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The phase 3 LAURA clinical trial demonstrated significant progression-free survival benefits for osimertinib in patients with unresectable stage III EGFR-mutant non-small cell lung cancer (NSCLC) after chemoradiotherapy. Lead author Dr. Suresh S. Ramalingam discusses the trial’s findings and their implications for clinical practice with Dr. Robert A. Figlin, highlighting osimertinib’s efficacy, safety profile, and impact on disease progression patterns.
Key Points:
- Osimertinib improved median progression-free survival to 39.1 months compared to 5.6 months with placebo (hazard ratio 0.16).
- The two-year progression-free survival rate was 65% with osimertinib versus 13% with placebo.
- Osimertinib reduced intracranial progression (8% vs 29%) and new lesion development (22% vs 68%) compared to placebo.
- The study included patients with unresectable stage IIIA, IIIB, and IIIC NSCLC who received either concurrent or sequential chemoradiotherapy.
- Toxicity profile was manageable, with slightly higher rates of radiation pneumonitis (48% vs 38%) and interstitial lung disease (8%) in the osimertinib group.
- EGFR mutation detection can be performed using either tissue biopsy or circulating tumor DNA.
- Treatment with osimertinib is recommended to continue until disease progression or unacceptable toxicity.
“These results clearly show that earlier initiation of therapy is important because the progression in the brain was almost two-thirds lower (8% for patients treated with osimertinib compared to 29% in the placebo group).”
– Dr. Suresh S. Ramalingam, Lead Study Author and the Roberto C. Goizueta Distinguished Chair for Cancer Research and the Executive Director at the Winship Cancer Institute of Emory University
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