Evaluating Pemetrexed Exposure in FLAURA2: Key Findings and Treatment Implications

FLORA-2 Outcomes Based on Pemetrexed Exposure

Main Discussion Topics:

• Analysis of FLAURA2 outcomes based on duration of pemetrexed exposure
• Implications for real-world implementation of the regimen
• Factors influencing decisions about continuing vs discontinuing pemetrexed

Key Points for Physicians:

• Median exposure to platinum-based chemotherapy was 3 months; pemetrexed was 8.3 months; osimertinib was 22 months
• Similar progression-free survival was observed between patients receiving 3 to 9 months and 9 to 18 months of pemetrexed
• Decisions to discontinue pemetrexed are typically driven by toxicity or patient preference rather than efficacy concerns

Notable Insights:

Patients who received at least some pemetrexed maintenance beyond the initial combination phase appeared to derive the benefit of the regimen, suggesting flexibility in maintenance duration.

Clinical Significance:

Real-world implementation of FLAURA2 can incorporate individualized approaches to maintenance therapy duration while preserving efficacy benefits.