Dr. Clarke on Combination Approaches Beyond Progression on Osimertinib in Lung Cancer

Jeffrey M. Clarke, MD, assistant professor of medicine, Duke Cancer Institute, discusses combination approaches beyond progression on osimertinib (Tagrisso) in EGFR-mutant non—small cell lung cancer (NSCLC).

Several studies have looked at anti-VEGF therapies in combination with anti-EGFR therapies and have shown a consistent improvement in progression-free survival (PFS), says Clarke. However, one study that came out of Japan in 2018 showed that there was no improvement in overall survival with the combination of bevacizumab (Avastin) and erlotinib (Tarceva) compared with erlotinib alone, calling into question the future role of these agents.

In terms of anticipated approaches, data regarding the combination of ramucirumab (Cyramza) and erlotinib are expected, says Clarke. According to a press release, treatment with the combination led to an improvement in PFS. Additionally, there have been studies looking at different therapies following progression on osimertinib. Exciting data from the phase Ib TATTON study showed response rates ranging from 30% to 50% with the combination of savolitinib and osimertinib and a median duration of response of 8 months. Overall, physicians are looking at the rationale for combinations following progression on osimertinib, concludes Clarke.