Αρχική World News No OS Benefit in EGFR T790M Advanced NSCLC Treated with Osimertinib vs...

No OS Benefit in EGFR T790M Advanced NSCLC Treated with Osimertinib vs Chemotherapy

In patients with epidermal growth factor receptor (EGFR) T790M advanced non-small cell lung cancer (NSCLC), no statistically significant benefit in overall survival (OS) was observed with osimertinib comparing to platinum-pemetrexed treatment, which possibly reflects the high crossover rate of patients from the therapy with platinum-pemetrexed to osimertinib. The final results from the AURA3 study were reported on 27 August 2020 in the Annals of Oncology by Prof. Yi-Long Wu of the Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital and Guangdong Academy of Medical Sciences in Guangzhou, China and colleagues. The hazard ratio (HR) for median OS was 0.87, while analysis of OS adjusted for crossover showed the HR of 0.54. High percentage (73%) of patients treated with platinum-pemetrexed chemotherapy were subsequently treated with osimertinib in this study.

Osimertinib is a third-generation, irreversible, oral EGFR tyrosine kinase inhibitor (TKI) that potently and selectively inhibits both EGFR TKI sensitising and T790M resistance mutations and has demonstrated efficacy in NSCLC, including central nervous system metastases.

The authors wrote in the study background that in the AURA3 (NCT02151981), osimertinib significantly prolonged progression-free survival (PFS) and improved response in patients with EGFR T790M advanced NSCLC and progression on prior EGFR TKI treatment. In their article published on 27 August 2020 in the Annals of Oncology, the AURA3 investigators reported the final OS analysis in this study.

In the AURA3, adult patients were randomised 2:1 to osimertinib given orally 80 mg once daily or pemetrexed plus carboplatin/cisplatin given intravenously, every 3 weeks, up to 6 cycles. Patients could crossover to osimertinib on progression confirmed by blinded independent central review. The OS and safety were study secondary endpoints.

In total, 279 patients were randomised to osimertinib; 140 patients were randomised to platinum-pemetrexed from whom 136 received the treatment. At data cut-off of 15 March 2019, 188 patients (67%) receiving osimertinib and 93 patients (66%) receiving platinum-pemetrexed had died.

The HR for OS was 0.87 (95% confidence interval [CI] 0.67–1.12; p = 0.277) with the median OS 26.8 months (95% CI 23.5–31.5) versus 22.5 months (95% CI 20.2–28.8), respectively. The estimated 24- and 36-month survival was 55% versus 43% and 37% versus 30%, respectively.

After crossover adjustment, the HR was 0.54 (95% CI 0.18–1.6). Time to first subsequent therapy or death showed a clinically meaningful advantage towards osimertinib, HR 0.21 (95% CI 0.16–0.28; p < 0.001). At data cut-off, 99 of 136 patients (73%) in the platinum-pemetrexed arm had crossed over to osimertinib, 66 of 99 (67%) of whom had died. Among patients receiving subsequent anticancer therapy, platinum chemotherapy was most common after osimertinib (65%)

The most common adverse events possibly related to study treatment were diarrhoea (32%; grade ≥3, 1%) and rash (grouped term; 32%; grade ≥3, <1%) in the osimertinib arm versus nausea (47%; grade ≥3, 3%) in the platinum-pemetrexed arm. Grade ≥3 possibly treatment-related adverse events have been observed less frequently with osimertinib (9%) than with platinum-pemetrexed (34%).

The authors concluded that no statistically significant benefit in OS was observed for osimertinib versus platinum-pemetrexed in the AURA3, possibly reflecting the high crossover rate of patients from the platinum-pemetrexed arm to receive the treatment with osimertinib. The continued tolerable safety profile reported for osimertinib, together with superior PFS, improved patient quality of life and longer time to symptom deterioration versus platinum-pemetrexed, reinforces osimertinib as standard of care second-line treatment for patients with EGFR T790M advanced NSCLC and disease progression on a prior EGFR TKI treatment.

The study was funded by AstraZeneca. 

Reference

Papadimitrakopoulou VA, Mok TS, Han J-Y, et al. Osimertinib versus platinum-pemetrexed for patients with EGFR T790M advanced NSCLC and progression on a prior EGFR-tyrosine kinase inhibitor: AURA3 overall survival analysis. Annals of Oncology; Published online 27 August 2020. DOI: https://doi.org/10.1016/j.annonc.2020.08.2100

Source

NEWSLETTER

Συμπληρώστε το email σας για να λαμβάνετε τις σημαντικότερες ειδήσεις από το ogkologos.com

Βρείτε μας

2,449ΥποστηρικτέςΚάντε Like
57ΑκόλουθοιΑκολουθήστε

Διαβαστε Επίσης

ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ)

ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ) Γράφει ο Δρ Παπαδούρης Σάββας, Παθόλογος-Ογκολόγος   Ο ΜΜΚΠ βρίσκεται αναλογικά στο 80% και πλέον του συνολικού...

Διατρέχουν όντως οι καρκινοπαθείς μεγαλύτερο κίνδυνο λόγω κοροναϊού;

Σε πρακτικό επίπεδο, τα δεδομένα των σχετικών μελετών υποδηλώνουν ότι η χημειοθεραπεία ή οι άλλες αντι-νεοπλασματικές θεραπείες δεν αυξάνουν σημαντικά τον κίνδυνο θνησιμότητας από...

FDA: Η ακτινοβολία των smartphones δεν προκαλεί καρκίνο

Σε μια νέα έκθεσή της, η Υπηρεσία Τροφίμων και Φαρμάκων (FDA) των ΗΠΑ αναφέρει ότι επανεξέτασε τις σχετικές επιστημονικές έρευνες που δημοσιεύθηκαν τα τελευταία...

Νέα ανακάλυψη, νέα ελπίδα για τον καρκίνο

Ένα νεοανακαλυφθέν τμήμα του ανοσοποιητικού μας συστήματος θα μπορούσε να αξιοποιηθεί για την αντιμετώπιση όλων των ειδών καρκίνου, σύμφωνα με επιστήμονες του πανεπιστημίου Cardiff...

Καρκίνος: Ευεργετική για τους καρκινοπαθείς η άσκηση

Σημαντικά ωφέλη προσφέρει η άσκηση, ακόμη και σε ασθενείς με καρκίνο. Οι περισσότεροι ασθενείς αγνοούν τα οφέλη που μπορεί να έχει γι’ αυτούς η συχνή...

Prostate Cancer

The article is provided by Scientific Communications Officer of NIPD Genetics, Ms Marina Charitou (MSc) Prostate Cancer Awareness Prostate cancer is the second most common cancer...
- Advertisment -

Ροή Ειδήσεων

FDA Approves Companion Diagnostic to Identify NTRK Fusions in Solid Tumours for Larotrectinib

On 23 October 2020, the US Food and Drug Administration (FDA) approved the next-generation sequencing (NGS)-based FoundationOne CDx test (Foundation Medicine, Inc.) as a...

An existing blood test for ovarian cancer has been re-evaluated. The results are in.

Ovarian cancer is the sixth most common cancer in women in the UK, with about 7,400 new cases every year. This number equates to...

Teacher Is Glad She Asked for More Testing After Mammogram Failed to Detect Her Breast Cancer

Martha Gray has a long history of breast cancer in her family, so she knows that she needs to take her mammograms seriously every...

How to Stay Healthy After Cancer

I try to pack helpful advice into every follow-up visit I have with patients, focusing on little tips that help foster healthy lifestyles. This...

Feasibility and Preliminary Efficacy Results of the Beat AML Study

Precision medicine in acute myeloid leukaemia (AML) is feasible in terms of providing cytogenetic and mutational data within 7 days, allowing their rapid incorporation into...

Woman Battles Breast Cancer While Pregnant, Delivers Healthy Baby Boy

When she was six months pregnant, Desiree Doughty noticed that something seemed to be wrong with her breasts. “I noticed that one of my breasts...