Tagrisso After Chemoradiation Reduced Progression Risk in NSCLC

Post-chemoradiation Tagrisso led to patients with EGFR-mutant stage 3 non-small cell lung cancer being nearly three times less likely to experience disease progression when compared with those treated with Imfinzi or who underwent observation.

Treatment with Tagrisso (osimertinib) following chemoradiation resulted in patients with EGFR-mutant stage 3 non-small cell lung cancer being nearly three times less likely to experience disease progression when compared with those treated with Imfinzi (durvalumab) or who were subject to observation.

Researchers determined that the 24-month progression-free survival rate (rwPFS; the time a patient lives without their disease spreading or worsening) among patients with stage 3 EGFR-mutant NSCLC who were treated with concurrent chemoradiation and who received consolidation Tagrisso or consolidation Imfinzi were 86% and 30%, respectively, versus a 24-month rwPFS rate of 27% for patients who received observation following concurrent chemoradiotherapy, according to recent study findings published in the Journal of Thoracic Oncology.

“This study suggests that among patients with stage 3 unresectable NSCLC with a sensitizing EGFR mutation, consolidation [Tagrisso] was associated with significantly longer rwPFS than [Imfinzi] or observation,” researchers wrote, further noting that “no unanticipated safety signals were observed with consolidation [Tagrisso].”

Learn more: Tagrisso-Chemo Combo Reduces Progression Risk in EGFR-Positive NSCLC With Central Nervous System Metastases

“[Tagrisso] is a drug that is actually very specific for the EGFR mutation itself,” said Dr. Amin Nassar, co-first author on the study, clinical fellow and member of the Yale Cancer Center, in a news release. “It has proven to be very efficacious in the stage 4 setting and also, more recently with the ADAURA trial, in the stage 3 setting. We wanted to find out in the unresectable [tumor not removable with surgery] stage 3 population, are we going to see similar benefits? And is this targeted therapy actually better than immunotherapy for these specific patients?”

Tagrisso is a targeted therapy intended to induce cell death and inhibit tumor growth in EGFR-overexpressing tumor cells, while the immunotherapy drug, Imfinzi, is designed to help a patient’s own immune system kill cancer cells, as explained by the National Cancer Institute.

In a retrospective analysis of 136 patients treated in 24 institutions between 2015 and 2022 — 56 of whom received Imfinzi, 33 of whom received Tagriso and 47 of whom received observation alone — at a median follow-up of 46 months the median duration of treatment was 5.5 months for Imfinzi and not reached for Tagrisso, meaning more than half of the patients in that cohort were still receiving treatment.

Learn more: Tagrisso Plus Chemo Gets Priority Review for Metastatic EGFR-Mutant NSCLC

There was, however, no notable difference observed in overall survival (OS; the time a patient lives following treatment, regardless of disease status), which researchers attributed as possibly to limited follow-up.

Any-grade side effects and grade 3 or higher side effects occurred in 52% and 6.1% of patients treated with Tagrisso and 48% and 18% of patients treated with Imfinzi, respectively. Among 45 patients who experienced disease progression on Imfinzi, 37, or 82%, later were treated with EGFR tyrosine kinase inhibitors, and in that group of patients 14, or 38%, developed treatment-related side effects, including five cases each of pneumonitis (inflammation of the lung tissues) and diarrhea.

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