Dr. Fidler on RELAY Trial Results in EGFR+ NSCLC

Mary J. Fidler, MD, associate professor, Rush University Medical Center, discusses the results of the phase III RELAY trial in treatment-naïve patients with EGFR-mutant non—small cell lung cancer (NSCLC).

The RELAY trial is studying the potential benefit of adding an angiogenic inhibitor to frontline TKI therapy, explains Fidler. Some signals were seen when using bevacizumab (Avastin) in a similar study in the United States, but the RELAY trial in Japan using erlotinib (Tarceva) had more positive responses. This is because erlotinib is a monoclonal antibody targeting the receptor rather than the circulating VEGF protein, says Fidler.

The RELAY trial in Japan randomized patients to receive erlotinib plus ramucirumab or placebo. Results presented at the 2019 ESMO Congress showed that the erlotinib plus ramucirumab combination had a median progression-free survival of 19.4 months versus 12.4 months for erlotinib plus placebo, resulting in a 41% reduction in the risk of disease progression or death (HR, 0.59; 95% CI, 0.46-0.79; P ≤.0001) at a median follow-up of 20.7 months. Despite these data, erlotinib is not the most-used drug in United States prescribing patterns for treatment-naïve patients with EGFR-mutant NSCLC, concludes Fidler.