Researchers have discovered that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors may improve survival outcomes after treatment with chemoradiation in patients with stage III EGFR-mutated non–small cell lung cancer (NSCLC) compared to the PD-L1 inhibitor durvalumab, according to new findings presented by Nassar et al at the International Association for the Study of Lung Cancer (IASLC) 2023 World Conference on Lung Cancer (Abstract MA16.11).
Durvalumab has been the standard of care to improve survival in patients with stage III NSCLC when prescribed after chemoradiation therapy. However, patients with EGFR-mutated NSCLC may not see the same survival benefit.
EGFR tyrosine kinase inhibitors are targeted therapies designed to block certain proteins that help cancer cells advance and metastasize.
Study Methods and Results
In the new study, the researchers analyzed the outcomes of 89 patients with stage III EGFR-mutated NSCLC who were treated between 2015 and 2022. The researchers found that the patients who received chemoradiation followed by EGFR tyrosine kinase inhibitors lived longer compared with those who received durvalumab after chemoradiation or those who had no additional treatment. They noted that 86% of the patients treated with chemoradiation followed by EGFR tyrosine kinase inhibitors lived at least 2 years longer without recurrence. Further, the patients in the EGFR tyrosine kinase inhibitor group experienced a higher disease-free survival rate compared with those in the durvalumab group (38%) or those in the no treatment group (29%).
The researchers reported that about 50% of the patients experienced negative side effects from both EGFR tyrosine kinase inhibitors and durvalumab following chemoradiation. However, the side effects were rarely severe.
Conclusions
“Our study provides new hope for patients with stage III EGFR-[mutated NSCLC]. The results show that EGFR [tyrosine kinase inhibitors] used after chemoradiation are effective for patients with this genetic mutation and improve survival,” emphasized lead study author Amin Nassar, MD, a hematology/oncology fellow at the Yale Cancer Center. “This data could be important for tailoring treatment plans for different patient groups and improving outcomes for patients with advanced lung cancer. While these findings are exciting, further research is needed to confirm the best treatment strategy for patients with stage III EGFR-[mutated] NSCLC,” he concluded.
