Study: Tagrisso More Effective Than Chemotherapy for NSCLC

According to the results of the recent AURA3 trial, Tagrisso (osimertinib; AstraZeneca) demonstrated superiority over chemotherapy as a second-line treatment among patients with epidermal growth factor receptor (EGFR) T790M mutation-positive metastatic non-small cell lung cancer (NSCLC).  

“The confirmatory Phase III data suggest the potential for Tagrisso to replace chemotherapy as the standard of care for patients who have progressed following EGFR tyrosine kinase inhibitor treatment,” Sean Bohen, MD, PhD, executive vice president, global medicines development and chief medical officer at AstraZeneca, said in a press release. “As lung cancer is the most common type of cancer to spread to the brain, it is also encouraging to see the activity of Tagrisso in patients with central nervous system metastases whose prognosis is often particularly poor.”

The study, a randomized, international, open-label, phase 3 trial, was published in the New England Journal of Medicine. The researchers found that Tagrisso second-line therapy improved progression-free survival by 5.7 months, when compared with standard platinum-based doublet chemotherapy (P < .001). Progression-free survival among 34% of patients with central nervous system metastases at baseline was 8.5 months with Tagrisso, vs 4.2 months with platinum-pemetrexed chemotherapy.

Study results also showed that Tagrisso safety data were in line with pervious observations. The most common drug-related adverse events in the Tagrisso group were diarrhea and rash. In the chemotherapy group, adverse events were nausea and decreased appetite.

The researchers wrote that “overall, adverse events tended to be more severe in the platinum–pemetrexed group, despite the longer treatment duration with [Tagrisso].” 

“The results of AURA3 are not only statistically significant, but clinically meaningful because it is the first time a targeted medicine like Tagrisso has shown improvement in progression-free survival over standard platinum-pemetrexed chemotherapy,” Vassiliki A Papadimitrakopoulou, MD, of the University of Texas MD Anderson Cancer Center, said in the press release. “It’s very rewarding to be able to give this type of news to patients, as it highlights the major advances we are making in targeted lung cancer treatments.”

—Julie Mazurkiewicz

Reference:

Mok TS, Wu Y, Ahn M, et al. Osimertinib or Platinum–Pemetrexed in EGFR T790M–Positive Lung Cancer [published online December 6, 2016]. N Eng J Med. DOI: 10.1056/NEJMoa1612674.