Weighing Chemo Risks: Post-op Adjuvant and Stage IV Settings

I’d like to compare and contrast the thoughts about using chemotherapy in the postoperative adjuvant setting vs in the stage IV setting. I think the clearest answer is in patients in the adjuvant setting. Please remember that after a curative surgery — the goal of which exactly was that, to cure the patient — we are again using systemic therapies to enhance the chance of cure. In that case, I think we need to pull out all the stops to use whatever therapies we have to increase the chance of cure.

The first treatment that’s been proven to improve that chance of cure is chemotherapy. Recently, we did a survey among my practice group. I would say that all 20 people said that they would administer chemotherapy in addition to osimertinib in patients who had a completely resected tumor and an EGFR mutation.

I know that, in the clinical trial, not all patients received chemotherapy, but I think it’s the feeling — of at least my practice group — that everybody would get chemotherapy with osimertinib if they had an EGFR-mutant cancer. Watch or read transcript here.