Lara Kujtan, MD, assistant professor at the University of Missouri—Kansas City School of Medicine, discusses frontline therapy for patients with 

-positive non—small cell lung cancer (NSCLC).

Based on the FLAURA study, osimertinib (Tagrisso) has become the frontline standard of care for patients with 

-mutant NSCLC, says Kujtan. In the trial, the EGFR TKI showed an improvement in progression-free survival (PFS) over gefitinib (Iressa) and erlotinib (Tarceva), meeting the study’s primary endpoint of improvement in PFS. Further, subgroup analysis revealed a consistent benefit across all subgroups, especially in patients with central nervous system (CNS) metastases, she adds. However, the overall survival data are still immature.

In the ARCHER 1050 study, investigators compared the use of dacomitinib (Vizimpro), a second-generation EGFR TKI, with common regimens such as erlotinib and bevacizumab (Avastin) or gefitinib and chemotherapy, says Kujtan. Although these studies revealed a survival benefit, no CNS activity was observed.

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Lara Kujtan, MD, assistant professor at the University of Missouri–Kansas City School of Medicine, discusses frontline therapy for patients with EGFR-positive non–small cell lung cancer (NSCLC).

Dr. Kujtan on Frontline Therapy for EGFR-Positive NSCLC

Lara Kujtan, MD, assistant professor at the University of Missouri—Kansas City School of Medicine, discusses the importance of patient preferences in the treatment of oncogene-driven non-small cell lung cancer (NSCLC).

Although there are many targeted therapies for 

-mutated NSCLC that show survival benefit, it is important to remember the toxicities associated with these agents. Patients might prefer a regimen that is more tolerable than a regimen with severe associated adverse events, explains Kujtan.

In a trial presented at the 2018 World Lung Conference, investigators examined patient preferences regarding treatment for 

-positive NSCLC. For the trial, participants were asked to fill out a survey which involved a hypothetical scenario in which they had to choose between drug “A” and drug “B.” Drug “A” was associated with a better progression-free survival (PFS) but severe adverse events, whereas drug “B” provided less of a PFS benefit, but greater tolerability. Results revealed that half of patients opted for drug “A,” while the other half opted for drug “B.”

While some patients value longevity, others value less adverse events, states Kujtan; this underscores the importance of having conversations with patients regarding treatment plans in order to ensure that their preferences are factored into the decision-making process.

Lara Kujtan, MD, assistant professor at the University of Missouri–Kansas City School of Medicine, discusses the importance of patient preferences in the treatment of oncogene-driven non-small cell lung cancer (NSCLC).

Lara Kujtan, MD

Articles

Dr. Kujtan on Frontline Therapy for EGFR-Positive NSCLC

Dr. Kujtan on Patient Preferences in the Treatment of NSCLC