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Thomas E. Stinchcombe, MD, professor of medicine, Duke Cancer Institute, discusses pivotal trials that have reshaped the standard of care in non–small cell lung cancer (NSCLC).
Thomas E. Stinchcombe, MD, professor of medicine, Duke Cancer Institute, discusses pivotal trials that have reshaped the standard of care in non—small cell lung cancer (NSCLC).
The focus has been on targeted therapies because of the tremendous advances made last year. A phase III trial compared osimertinib (Tagrisso) with erlotinib (Tarceva) or gefitinib (Iressa) and revealed an improved progression-free survival (PFS), with a median PFS of about 18.9 months. This was in addition to a lower grade 3/4 toxicity. This was a practice-changing trial, notes Stinchcombe.
In ALK-rearranged NSCLC, there have been 2 important trials. Both trials compared alectinib (Alecensa) to the previous standard, crizotinib (Xalkori), and demonstrated a significant improvement in PFS, with a median PFS of 25 months. One of the trials prospectively assessed the development of brain metastases. It showed a dramatic reduction in the incidence of brain metastases, demonstrating the agent’s potency and blood-brain barrier penetration.