Brief Overview of Current Treatment Landscape for 1L EGFRm NSCLC
Panelists discuss how the treatment landscape for EGFR-mutated lung cancer has evolved, with 3 strong options now available, including single-agent osimertinib and 2 combinations: osimertinib plus chemotherapy (FLAURA2) and amivantamab plus lazertinib (MARIPOSA), with the latter showing significant overall survival benefits.
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First-Line EGFRm NSCLC Treatment Landscape Overview
Current Treatment Options
The treatment landscape for EGFR-mutated (EGFRm) non–small cell lung cancer (NSCLC) has evolved significantly, with 3 strong first-line options now available:
- Osimertinib monotherapy: The established standard treatment option
- Osimertinib plus chemotherapy: Combination supported by the FLAURA2 trial data
- Amivantamab plus lazertinib: Recent combination showing significant survival benefits in the MARIPOSA trial
Recent Advances: MARIPOSA Trial Results
The MARIPOSA trial, a randomized phase 3 study, compared 3 treatment regimens:
- Amivantamab plus lazertinib
- Osimertinib (control arm)
- Lazertinib plus osimertinib
Key Findings:
- Significant overall survival (OS) benefit: HR of 0.75 for amivantamab plus lazertinib compared with osimertinib monotherapy
- Sustained survival advantage: Survival curves separating early and continuing to widen over time
- Potential median OS improvement: Mathematical modeling suggesting up to 12-month difference in median survival (though median not yet reached for the treatment arm)
- Impressive landmark data: Progressive improvement in survival difference at 24, 36, and 42 months
The amivantamab plus lazertinib combination represents a novel mechanism targeting both EGFR and c-MET receptors, providing a valuable new option for first-line treatment of EGFRm NSCLC.
The trial continues with follow-up for a 5-year landmark analysis, with current survival projections suggesting beyond 4 years of median OS for patients receiving the combination therapy.
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