Marina Chiara Garassino, MD
In the wake of recent data presented at the 2018 ASCO Annual Meeting, the landscape of non–small cell lung cancer (NSCLC) continues to rapidly shift. Immunotherapy has consistently shown promise, but the future of treatment for many patients may be with combination chemoimmunotherapy, said Marina Chiara Garassino, MD.
, Garassino, chief of the Thoracic Oncology Unit at the National Cancer Institute of Milan, Italy, reflected on the first-line approval of osimertinib, recent data with durvalumab, and the promise for combination chemoimmunotherapy in patients with NSCLC.
OncLive: Can you reflect on some of the recent data that have been reported in NSCLC?
: Osimertinib remains the cornerstone [of treatment]—we have 19.2 months of progression-free survival (PFS) with a very low toxicity. However, the scientific community should not think that there are no other strategies to consider. A good option could be a strategy of erlotinib plus bevacizumab (Avastin) followed by osimertinib. There is just a 3-month increase in PFS.
There was also a very interesting Japanese trial adding chemotherapy to gefitinib. This trial had the best OS ever. It is a Japanese trial though, and those patients are different than Western patients. However, it is something that we have to consider because we have never seen a 50-month OS. This part of research should be considered for the future.
Are there any further studies with osimertinib?
The big problem with osimertinib is that we do not have any drug to overcome resistance, as the fourth-generation TKIs are far away [in development]. This is the most important problem of osimertinib because, currently, we have to move onto chemotherapy. Personally, we must find the right balance between the quality of life and the PFS for these patients. The combination with chemotherapy could be a nice option because of the 5 years of survival that were not seen before. One could consider to combine chemotherapy with an EGFR TKI is quite heavy for this population of patients who have been on therapy for several years.
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