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Osimertinib Plus Chemo Improves CNS PFS in EGFR+ Advanced NSCLC With Baseline Brain Metastases

*October 2023*

Osimertinib (Tagrisso) plus chemotherapy reduced the risk of central nervous system (CNS) disease progression or death vs osimertinib alone in patients with locally advanced or metastatic EGFR-positive non–small cell lung cancer (NSCLC) who had brain metastases at baseline, according to data from the phase 3 FLAURA2 trial (NCT04035486) presented at the 2023 ESMO Congress.

Ultimately, patients who received osimertinib with chemotherapy had an estimated 9% risk of developing a CNS lesion at 24 months (95% CI, 4-16) whereas those who received osimertinib alone had an estimated 23% risk (95% CI, 14-33).

Also, compared with osimertinib alone, adding chemotherapy to the EGFR tyrosine kinase inhibitor (TKI) contributed to a higher CNS objective response rate (ORR) and better complete response (CR) rate with durable responses, all with a tolerable and manageable safety profile.

“These data support the addition of platinum-pemetrexed to osimertinib as a new firstline treatment option for patients with an EGFR mutated, advanced non-small cell lung cancer, including those with brain [metastases],” David Planchard, MD, PhD, thoracic oncologist and head of the thoracic pathology committee at Institut Gustave Roussy in Paris, France, said during the presentation of the findings.

Prior reports have demonstrated that firstline osimertinib plus chemotherapy significantly improved progression-free survival (PFS) over osimertinib alone—this was consistent across all subgroups, including those with brain metastases. Read more.