Mutation-Defined Lung Cancer Trial Yields Hits and Misses for Targeted Therapy

Published: Tuesday, Sep 10, 2019

The RTK signaling group had 4 subgroups with DCB rates that exceeded the targets, and 3 of the 4 exceeded response targets. Crizotinib for tumors with ROS1 gene fusions and MET exon 14 skipping had DCB rates of 71% and 80%, respectively, and OR rates of 68%, both associated with PPoS >0.99. Osimertinib for EGFR T790M mutation had a 94% DCB and OR rate of 76%, with a PPoS >0.99. AZD4547 for FGFR mutation had passed the DCB target (31%), which was associated with a PPoS of 0.54. Crizotinib for tumors with MET amplification appeared unlikely to meet the DCB or response target.

In closing, Middleton showed the impact of smoking status and histology on the interim results. Light smokers (≤10 pack years) and never-smokers had response rates of 17% and 28%, respectively, as compared with patients who had smoking histories of 10 to 30 pack years (7%) and >30 pack years (10%). Similarly, responses occurred substantially more often among nonsquamous versus squamous tumors (16% vs 1%). He noted that 99% of the patients with squamous cell histology had been treated with palbociclib or capivasertib.
G. Middleton, S. Popat, P. Fletcher, et al. National Lung Matrix Trial (NLMT): first results from an umbrella phase II trial in advanced non-small cell lung cancer (NSCLC). Presented at: IASLC 20th World Conference on Lung Cancer; September 7-10, 2019; Barcelona, Spain. Abstract PL02.09.
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