A Podcast on Osimertinib After CRT in Unresectable Stage III EGFR-Mutated Non-Small Cell Lung Cancer (NSCLC): Current and Future Perspectives.
TL;DR
Overall, continuous systemic treatment post-CRT may be key to improving long-term outcomes and represents a mindset shift for both healthcare professionals and patients, which may need to consider unresectable stage III EGFRm NSCLC as a chronic disease, requiring long-term treatment to maintain suppression of disease.
Abstract
Epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) disease biology may differ from EGFR-wild type NSCLC, with an increased risk of distant metastases in unresectable stage III EGFRm NSCLC. Osimertinib is an established first treatment for patients with EGFRm advanced NSCLC, effectively treating EGFRm tumours. The phase III LAURA study, which assessed the efficacy and safety of osimertinib for patients with locally advanced, unresectable stage III EGFRm NSCLC who completed chemoradiotherapy (CRT) without disease progression, demonstrated a statistically significant improvement with osimertinib in progression-free survival (PFS), with a median PFS of 39.1 months, versus 5.6 months with placebo. The safety profile was as expected based on the known profiles of osimertinib and CRT. On the basis of the LAURA results, osimertinib has now been approved for the treatment of unresectable stage III EGFRm NSCLC. Given the implementation of the LAURA regimen in multiple countries, this podcast highlights the potential challenges that must be considered by healthcare professionals when administering osimertinib in clinical practice, and how these may be mitigated. Considerations of the impact of the 'treat-to-progression' approach, a paradigm shift for the treatment of stage III unresectable NSCLC, and patient-centred care, including the importance of shared decision-making, will also be discussed. Overall, continuous systemic treatment post-CRT may be key to improving long-term outcomes and represents a mindset shift for both healthcare professionals and patients. Therefore, we may need to consider unresectable stage III EGFRm NSCLC as a chronic disease, requiring long-term treatment to maintain suppression of disease.The podcast and transcript can be viewed below the abstract of the online version of the manuscript. Alternatively, the podcast can be downloaded here: https://doi.org/ https://doi.org/10.6084/m9.figshare.33191613 . Supplementary file1 (MP4 306769 KB).