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EGFR Tyrosine Kinase Inhibitor Sequencing Revisited: From the Revival of Old Tools to the Integration of New Agents

*September  2022*

In this issue of the Journal of Thoracic Oncology, Piccirillo et al. report the results of the BEVERLY trial, a randomized phase 3 study that reveals the progression-free survival (PFS) benefit of bevacizumab to erlotinib as first-line treatment for Italian patients with metastatic NSCLC with common EGFR mutations. In this large study, after a median follow-up of 36.3 months, median investigator-assessed PFS was 15.4 months with erlotinib plus bevacizumab and 9.6 months with erlotinib alone (hazard ratio = 0.66, 95% confidence interval: 0.47–0.92). These results add further evidence to that provided by previously reported randomized studies, mostly conducted in Asian patients, that investigated combinations of first-generation EGFR TKIs and antiangiogenic agents, including JO25567, NEJ026, CTONG-1509, and other trials with erlotinib and bevacizumab, and the RELAY trial with erlotinib and ramucirumab. Taken together, these studies reported on median PFS ranging from 16.4 to 19.4 months. Read more.