PFS of FLAURA Trial 18 Months Compared to 1st Gen TKIs

Paul K. Paik, MD of Memorial Sloan Kettering Cancer Center discusses the PFS of FLAURA trial compared to first generation TKIs. FLAURA trial was a very big news. The trial comes with frontline osimertinib versus the first generation EGFR TKI trials for patients with EGFR mutant lung cancer. As for now, FDA approval for the drug is still in progress, although the study was positive. The results were positive in the PFS standpoint. The PFS is quite long compared to that of the first gen TKI, somewhere around 18 months. Patients who receive the first generation TKI, such as erlotinib or afatinib have median PFS of around 10 months and develop resistant that harbours the T790 mutation. After that, patients will be available for osomirtneib with a median PFS of somewhere around 8 months. This is very important because for the first diagnosis of patient with EGFR mutation in lung cancer, the evidence of whether or not they’re gonna develop T790 M positive or negative disease is not clear. Generally, the odds is about 50-50 that they won’t, but if the median is not known, PFS would be worse, because patients will not get osomirtneib, instead they’ll get the first-line carboplatin-based chemotherapy, which is known in the sequence to have a shorter PFS that when osomirtneib is given up front. FDA approval for the osomirtneib as the front-line option is highly anticipated. At the end of day, this will be the best treatment for newly diagnosed patients.