First targeted therapy approved to prevent recurrence of early stage NSCLC

Lung cancer

By Mardi Chapman

7 Jun 2021

Osimertinib (Tagrisso) has been TGA registered as adjuvant therapy after tumour resection in early stage, EGFR-mutated non-small cell lung cancer (NSCLC).

It is the first targeted therapy available to prevent recurrence of disease in this patient group.

The evidence comes from the international ADAURA trial, which included Australian sites and investigators.

The RCT, published in the NEJM last year found an 83% reduction in the risk of disease recurrence or death in the osimertinib group compared to the control group.

In patients with stage II to IIIb disease, 90% of the osimertinib group were alive and disease-free at 24 months compared to 44% of controls (p<0.001).

Dr Steven Kao, from Chris O’Brien Lifehouse, told the limbic that osimertinib was also shown to significantly reduce the risk of brain metastases.

“Basically ADAURA showed that in stage Ib to IIIa, using Tagrisso for three years reduces the chance of the cancer coming back by roughly 80%. It is quite dramatic. TGA approval is obviously the first step and we will wait for PBAC to make a judgment on funding.”

Dr Kao said there would likely be enthusiastic uptake of the treatment.

“If you are talking to patients about this, they would, I think, invariably want to take up this treatment paradigm. The problem is obviously the cost right now.”

He said while osimertinib was currently only for patients with early stage lung cancer, a greater proportion of lung cancer patients might benefit in the future.

“Stage IV disease is the predominant stage of disease which is why survival is so poor. This is not for stage IV patients. With the enthusiasm for lung cancer screening we hope to reduce the proportion of stage IV versus early stage and… in the future we would have more patients that are curative and therefore more to benefit from this kind of treatment.”

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