The EGFR Result at Progression and the Updated HARMONi Overall Survival Analysis

The faculty discuss what the EGFR result still tells clinicians when disease progresses on a third-generation EGFR tyrosine kinase inhibitor and what additional information is needed at that point. They then review the updated overall survival analysis from the phase 3 HARMONi study of ivonescimab plus chemotherapy after third-generation EGFR tyrosine kinase inhibitor therapy. The faculty note the longer follow-up in the Western cohort, that the Western cohort result on its own does not establish an overall survival benefit, and that its direction and magnitude have convergence with the global population. They also discuss the mechanism of action, counseling patients on toxicity, the need for longer follow-up, and the value of another option when no resistance mechanism is identified.