Dr Jänne on Key Areas of Ongoing Debate in EGFR+ NSCLC

"How long is the optimal duration of receiving adjuvant targeted therapy? And there are sort of variations of that, in terms of years, usually somewhere between two to three years...These are questions that we still have in the field."

Pasi A. Jänne, MD, PhD, senior vice president for Translational Medicine, director of the Belfer Center for Applied Cancer Science, director of the Chen-Huang Center for EGFR Mutant Lung Cancers, a senior physician, and the David M. Livingston, MD, Chair at Dana-Farber Cancer Institute; as well as a professor of medicine at Harvard Medical School, discussed key areas of ongoing debate in EGFR-mutant non–small cell lung cancer (NSCLC) covered in the Global Bridging the Gaps in Lung Cancer meeting.

The most frequently debated topics included neoadjuvant versus adjuvant targeted approaches, the selection of appropriate patients, and determining the optimal duration of therapy, Jänne noted.

Jänne emphasized that one of the key unresolved questions in the field concerns the optimal duration of receiving adjuvant targeted therapy. Current clinical practice demonstrates variations in the length of treatment. Although the duration of targeted therapy is typically measured in years, it usually falls somewhere between 2 to 3 years. However, Jänne pointed out that there are certain clinical situations where targeted therapy is administered indefinitely.

This indefinite duration of treatment is observed in studies such as the phase 3 LAURA trial (NCT03521154), which evaluated consolidation osimertinib (Tagrisso) following chemoradiation in patients with unresectable, stage III EGFR-mutant NSCLC who had received previous chemotherapy and radiation

Jänne stated that despite the variability in current practice, it is important to establish a clear definition or gain an understanding of what constitutes the optimal duration of adjuvant therapy. Although this understanding is needed, the studies required to fully determine the optimal duration take a long time to complete, Jänne concluded.