Journal Article

Osimertinib or Platinum–Pemetrexed in EGFR T790M–Positive Lung Cancer

Wu, Yi-Long, Ahn, Myung-Ju, Ramalingam, Suresh S, Theelen, Willemijn S.M.E, Lee, Chee K, Mok, Tony S, Mann, Helen, Sebastian, Martin, Templeton, Alison, He, Yong, Marotti, Marcelo, Akamatsu, Hiroaki, Kim, Hye R, Ghiorghiu, Serban, Shepherd, Frances A, Papadimitrakopoulou, Vassiliki A, Garassino, Marina C

2017

Overview

In a randomized trial involving patients with non–small-cell lung cancer with mutant EGFR (T790M) in whom a tyrosine kinase inhibitor had failed, osimertinib was associated with significantly longer progression-free survival than platinum therapy plus pemetrexed. Among patients with advanced non–small-cell lung cancer with a mutant epidermal growth factor receptor (EGFR), EGFR tyrosine kinase inhibitors (TKIs) are the standard first-line therapy. 1 – 4 Despite high tumor response rates with first-line EGFR-TKIs, disease progresses in a majority of patients after 9 to 13 months of treatment. 5 – 12 At the time of progression, approximately 60% of patients (regardless of race or ethnic background) are found to have a p.Thr790Met point mutation (T790M) in the gene encoding EGFR. 13 – 16 The presence of the T790M variant reduces binding of first-generation or second-generation EGFR-TKIs to the ATP-binding pocket of EGFR, thereby reducing . . .

• Publisher: Massachusetts Medical Society
• Subject: Acrylamides / Adult / Aged / Aged, 80 and over / Aniline Compounds / Antineoplastic Combined Chemotherapy Protocols - adverse effects / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Cancer therapies / Carboplatin / Carcinoma, Non-Small-Cell Lung - drug therapy / Central nervous system / Cisplatin / Disease-Free Survival / Drug dosages / Enzyme inhibitors / Epidermal growth factor / Epidermal growth factor receptors / ErbB Receptors - antagonists & inhibitors / FDA approval / Fees & charges / Female / Humans / Intravenous administration / Lung cancer / Lung diseases / Lung Neoplasms - drug therapy / Male / Metastases / Metastasis / Middle Aged / Mutation / Oncology / Pemetrexed - administration & dosage / Pemetrexed - adverse effects / Pharmaceuticals / Piperazines - administration & dosage / Piperazines - adverse effects / Platinum / Platinum - administration & dosage / Protein-tyrosine kinase receptors / Response rates / Targeted cancer therapy / Young Adult