In this exclusive MedPage Today video, Roy Herbst, MD, PhD, of Yale Cancer Center in New Haven, Connecticut, discusses exciting new data surrounding osimertinib (Tagrisso) in patients with EGFR-mutated non-small cell lung cancer (NSCLC) from both the LAURA and ADAURA trials, including improvements in progression-free survival (PFS) in stage III patients and the potential of using minimal residual disease to predict optimal length of treatment.

The findings from both studies were presented at the recent American Society of Clinical Oncology (ASCO) meeting.

Following is a transcript of his remarks:

In non-small cell, we take the findings of the ADAURA trial of last year, which actually I was privileged to present in the plenary session, looking at osimertinib in adjuvant settings in lung cancer with a 51% improvement in survival.

This year that’s taken to another setting of disease, locally advanced disease. Stage III lung cancer is about a third of non-small cell lung cancer, which was about 85% of lung cancer in general. So it’s a lot of patients. And these patients who have the EGFR mutation, they ordinarily would not have anything after they get their chemoradiation. Sometimes they get prophylactic radiation to the brain.

But now in this study that was conducted worldwide, patients were randomized to receive osimertinib versus a placebo. Why a placebo? Because there is no standard of care for patients with EGFR mutation after they get the chemoradiation.

And I just saw the results this morning and they’re phenomenal. I believe the hazard ratio was 0.1, 0.2 — an 80% improvement. The curves separate enormously. There’s no doubt that there’s an improvement in progression-free survival in this setting, in stage IIIA, IIIB, and IIIC disease.

The question will be how long does one treat? In this trial, the patients were treated until progression. I’m hoping that with minimal residual disease analysis, some patients might need less therapy, which would be perhaps fewer side effects and less inconvenience. We actually have an abstract from the ADAURA trial that we’re presenting at this meeting that’s actually showing that you can use minimal residual disease by looking at cell-free DNA to predetermine who may or may not be recurring. So perhaps that could be a way to determine the length of therapy.

So really phenomenal. We’ll see that at the plenary.

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