Pilar Garrido, MD, PhD

At a press conference at the ESMO Congress 2019, Pilar Garrido, MD, PhD, of Ramon y Cajal University Hospital, Madrid, commented on the FLAURA trial: “These results are good news for patients with lung cancer, which is the most common cause of cancer deaths. Advances in the understanding of the molecular basis for non–small cell lung cancer and the emergence of treatments with new targets allow us to identify subsets for specific treatments. About 10% to 15% of Caucasian patients and 40% of Asian patients with non–small cell lung cancer have an EGFR-sensitizing mutation, and the results of FLAURA are relevant for them,” she told listeners.

“The drug has a good safety profile, good central nervous system penetration, and improved progression-free and overall survival, so it is a good option in the first-line treatment of advanced disease,” Dr. Garrido added.

Sequencing of treatments is also important, she continued, since osimertinib is the only tyrosine kinase inhibitor approved for second-line treatment for patients who develop resistance because of T790M. “If osimertinib is used as first-line therapy, there is no tyrosine kinase inhibitor available when the disease progresses. Patients should be told that osimertinib offers a survival advantage and is well tolerated, but when the treatment fails, chemotherapy is the only option. Maximizing the duration of chemotherapy-free treatment is important for patients, but if we want to know the most effective sequence of tyrosine kinase inhibitors, we need studies specifically designed for that,” explained Dr. Garrido.

“To improve survival, we need to be sure that all our patients are tested for EGFR mutations and that the EGFR [tyrosine kinase inhbitors] are available for them,” she stated. ■

DISCLOSURE: Dr. Garrido has had a consulting/advisory role with Roche, MSD, BMS, Boerhinger Ingelheim, Pfizer, AbbVie, Guardant Health, Novartis, Lilly, AstraZeneca, Janssen, Sysmex, Blueprint Medicines, and Takeda; was a speaker for Roche, MSD, BMS, Pfizer, Novartis, Boehringer Ingelheim, AstraZeneca, Takeda, and Rovi; and has received research support from Guardant Health and Sysmex.