EGFR Flashcards
Describe the patient population, study arms, primary endpoint and results of the FLAURA trial
FLAURA
Frontline metastatic NSCLC, EGFR mutated (exon 19 del, L858R)
Osimertinib versus Erlotinib/Gefitinib
primary endpoint: Progression free survival
18.9 months versus 10.2 (HR 0.46)
Soria, J.C NEJM 2018, PMID: 29151359
Describe the patient population, study arms, primary endpoint and results of the MARIPOSA
MARIPOSA
Frontline metastatic NSCLC, EGFR mutated (exon 19 del, L858R)
2:2:1 ratio, amivantamab-lazertinib : osimertinib : lazertinib
primary endpoint: Progression free survival
23.7 months (ami-laz) versus 16.6 months (osimertinib)
Cho B.C NEJM 2024,PMID 38924756
Name the 2 classic EGFR mutations seen in NSCLC
- Exon 19 deletion
- L858R (in exon 21) switch from thymine to guanine at codon 858
Describe the patient population, study arms, primary endpoint and results of the FLAUR2 trial
FLAURA2
Frontline metastatic NSCLC, EGFR mutated (exon 19 del, L858R)
1:1 randomized to either chemotherapy + osimertinib or osimertinib
primary endpoint: progression free survival
at 24 months: 57% (chemo+osi) versus 41% (osi only)
Planchard D, NEJM 2023, PMID 2306434
What are three systemic treatment options for newly diagnosed metastatic EGFR mutated NSCLC
- Osimertinib - FLAURA
- Osimertinib + chemotherapy - FLAURA2
- Amivantimab + Lazertinib - MARIPOSA
What is the most common resistance mutation noted in patients with metastatic EGFR who receive frontline treatment with an early generation TKI such as erlotinib/afatinib?
T790M
EGFR - Adjuvant following resection
Describe the patient population, study arms, primary endpoint and results of the ADUARA trial (hint: adjuvant)
ADUARA
Resected stage IB-IIIA, non-squamous, EGFR (exon 19 del, L858R)
1:1 randomized to either osimertinib versus placebo x 3 years
primary endpoint: disease free survival in stage II-IIIa
at 24 months: 90% in osimertinib versus 44% in placebo
Yi-Long W, NEJM 2020, PMID 2027071
Herbst R, JCO 2024, PMID 36720083
