Dr. Suresh Ramalingam on Frontline Osimertinib in EGFR+ NSCLC

Suresh Ramalingam, MD, professor of Hematology and Medical Oncology at Emory School of Medicine and deputy director of Winship Cancer Institute, discusses first-line treatment with single-agent osimertinib in patients with EGFR-mutated non—small cell lung cancer (NSCLC).

As part of a phase I study, 60 patients with EGFR-mutated NSCLC received 80 or 160 mg of frontline osimertinib, which inhibits T790M mutation, a known driver of resistance to EGFR TKI. Updated efficacy data, reported at the ELCC meeting, demonstrated a response rate of around 76% in patients who received frontline osimertinib. The median duration of response has not yet been reached in the group receiving the 80 mg dose of osimertinib, as the majority of patients included in the study are still continuing to receive therapy, says Ramalingam. The median duration of response was 16.7 months in the patient group that receiving the 160 mg dose.

The median progression-free survival (PFS) was 19.3 months for patients receiving osimertinib at 160 mg once daily (n = 30) and was not yet reached for patients receiving the 80 mg dose (n = 30). This PFS is significant when compared to existing therapies for EGFR-mutated NSCLC, which have a the median PFS of around 9 to 13 months, says Ramalingam.

The regimen was well tolerated and most toxicities were grade I or II, he adds.

Osimertinib is currently approved by the FDA for patients with advanced EGFR T790M mutation—positive NSCLC who are resistant to EGFR TKI.

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