Osimertinib (Tagrisso) has impressed researchers in the field of EGFR
-mutant non–small cell lung cancer (NSCLC), most recently with results from the phase III FLAURA trial solidifying its benefit.
In an interview during the meeting, Fidler discussed the promise of novel therapies in these subpopulations.
OncLive: Could you share your insight on the recent data with osimertinib?
We saw a nice phase III trial comparing osimertinib with standard frontline platinum-based doublet chemotherapy in patients who had progressed on a first-generation TKI with T790M as a secondary mutation. That trial clearly showed a benefit of osimertinib over platinum doublet chemotherapy.
I also spoke about osimertinib in the frontline setting, as we now have data from the FLAURA trial. This trial compared osimertinib with erlotinib (Tarceva) or gefitinib (Iressa) as a frontline agent, and the PFS data are really impressive. The overall survival data are not yet mature, but [osimertinib] seems to be better tolerated and is a real winner in that trial.
What challenges still exist in targeting EGFR-mutant NSCLC?
Unfortunately, all patients will still progress. The PFS data with osimertinib in the frontline setting goes out to the median of 18 months, which is great, but all patients will progress. The challenge we have now is, how do we keep people on targeted agents? There is some preliminary work looking at mechanisms of resistance for osimertinib. We have some information on first- and second-generation EGFR TKIs, but finding the right combination of protein therapy to counteract resistance is important.
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