Dr Gold on the Benefit of Targeted Therapies in Mutated Lung Cancers

Kathryn A. Gold, MD, medical oncologist, professor, medicine, University of California, San Diego (UCSD), Moores Cancer Center, UCSD Health, discusses the benefit of targeted therapies in patients with mutated lung cancers.

In the lung cancer setting, the application of targeted therapies has been primarily associated with the treatment of patients with metastatic lung cancer, she begins. However, recent data indicate the potential efficacy of these therapies in cases where surgical resection is feasible. The phase 3 ADAURA (NCT02511106) and ALINA (NCT03456076) trials each shed light on the application of targeted therapies in distinct subgroups of patients with metastatic disease.

The ADAURA trial evaluated adjuvant osimertinib (Tagrisso), an EGFR-targeted TKI, in patients with EGFR-mutant lung cancer who had undergone surgical intervention, Gold explains. In this randomized trial, patients were assigned to receive either osimertinib or a placebo, with a primary end point of disease-free survival (DFS) and a key secondary end point of overall survival (OS), she states. The trial met both end points, demonstrating that osimertinib improved DFS and OS compared with placebo. Consequently, Gold says that in her clinical practice, osimertinib has now emerged as a new standard of care for patients with EGFR-mutant lung cancer post-surgery, with a recommended 3-year treatment duration.

The ALINA trial enrolled patients with surgically resected ALK-positive lung cancer, she continues. The trial sought to determine the efficacy of adjuvant chemotherapy compared with adjuvant alectinib (Alecensa) in this population over a 2-year period, Gold states. Although the full results of the trial, including the OS data, are still pending, preliminary data indicate a DFS improvement with alectinib compared with chemotherapy, she adds.

Overall, both the ADAURA and ALINA trials underscore the potential power of integrating targeted therapies into the early stages of lung cancer treatment, Gold emphasizes. The outcomes of these trials have expanded the understanding of the efficacy of targeted therapies and influenced clinical practices, Gold concludes.