The FDA's approval of osimertinib plus platinum-based chemotherapy for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring EGFR exon 19 deletions or exon 21 L858R mutations marks a significant advancement in treatment options. This decision is supported by the phase 3 FLAURA 2 study, which demonstrated a median progression-free survival of 25.5 months for the combination therapy, compared to 16.7 months for osimertinib alone.
The FLAURA 2 study was a randomized, multicenter, open-label trial that enrolled patients with specific EGFR mutations who had not received prior systemic treatment for advanced disease. Participants were treated with either osimertinib plus chemotherapy or osimertinib alone, with the combination therapy showing a higher objective response rate (77% vs. 69%) and longer duration of response (24.9 months vs. 17.9 months).
Safety data revealed that serious adverse reactions occurred in 38% of patients receiving the combination therapy, with 7% experiencing fatal toxicities. Common adverse effects included diarrhea, stomatitis, rash, nail toxicity, dry skin, and pruritus. Laboratory abnormalities such as leukopenia, thrombocytopenia, neutropenia, lymphopenia, and increased blood creatinine were also observed.
This approval provides a new treatment option for patients with EGFR-mutated NSCLC, offering hope for improved outcomes and quality of life.