Corey J. Langer, MD, FACP of the University of Pennsylvania talks about the FLAURA Trial Results and the 8-9 Month PFS in Treatment Naive EGFR patients. Based on the FLAURA Trial, Osimertinib is a game changer. The 8-9 months PFS is almost doubled. There is also equal or less toxicity with osimertinib, which means less rash, probably less diarrhea and less stomatitis compared to standard front-line EGFR TKIs and in this case, osimertinib versus either gefitinib or erlotinib. Theres an unexpected bonus as part of the presentation at ESMO in 2017 and more recently at World Lung in Yokohama. There is an observed trend towards improved survival. The P-value is below 0.05. However, because it was an early look of the data, it was not considered statistically significant.
At every endpoint, osimertinib appears superior to the front-line standard like the first generation TKIs. However, there are still remaining arguable points in using osimertinib, which made it an open area of inquiry. Therefore, for patients who developed resistance to osimertinib, patients should undergo re-biopsy, obtaining liquid biopsy, plasma testing for mutation analysis and tailoring other approaches accordingly.