Dr. Chaft on the Rationale for the OPAL Trial in EGFR+ NSCLC

Jamie E. Chaft, MD, a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the rationale behind the ​OPAL trial (NEJ032C/LOGIK1801) in EGFR-mutant non–small cell lung cancer (NSCLC).

Using first-generation TKIs, such as erlotinib (Tarceva) and gefitinib (Iressa), in combination with other agents can significantly improve outcomes for patients with NSCLC, says Chaft. For example, several studies have demonstrated that patients derive additionalbenefit from TKIs that are administered in combination with chemotherapy or antiangiogenic agents​, such as bevacizumab (Avastin) and ramucirumab (Cyramza), ​compared with TKIs alone, Chaft says.

Although first-generation TKIs used in combination ​regimens were found to be the better alternative over TKI monotherapy, it is important to weigh the ​potential improvement in outcome with ​the risk of toxicity and quality-of-life factors, Chaft explained.

Ultimately, this ​concept served as the rationale for the ongoing, multicenter, phase 2 OPAL trial, which is evaluating the safety and efficacy of osimertinib (Tagrisso) plus cisplatin/carboplatin and pemetrexed in patients with previously untreated EGFR-mutant NSCLC​. Preliminary safety results were presented during the 2020 ESMO Asia Virtual Congress and showed that the regimen was well tolerated among this patient population, Chaft concludes.