Chemotherapy Mixture Boosts General Survival in Patients with EGFR-mutant Non-Small Cell Lung Cancer

Final evaluation of Dana-Farber co-led section 3 FLAURA2 research underscore advantages of including chemotherapy to current customary first line remedy with an EGFR-TKI.

Treatment with osimertinib plus a platinum–pemetrexed chemotherapy mixture resulted in statistically vital and clinically significant enchancment in general survival in sufferers with newly identified EGFR-mutated superior non-small cell lung most cancers (NSCLC) in comparison with osimertinib alone. The discovering relies on an evaluation of the whole information from the section 3 world FLAURA2 research, co-led by researchers from Dana-Farber Cancer Institute and Gustave Roussy (Grand Paris, Villejuif, France). Median general survival was 47.5 months within the osimertinib plus platinum–pemetrexed group versus 37.6 months within the osimertinib monotherapy group.

The outcomes of the FLAURA2 trial had been offered at this time on the European Society for Medical Oncology (ESMO) Congress 2025 in Berlin, Germany, and revealed concurrently within the New England Journal of Medicine.

“This is the longest overall survival in this patient population that we’ve seen in any clinical trial to date. It shows that combination therapies can lead to improvements over a single agent. This data helps establish osimertinib plus chemotherapy as standard of care first-line therapy,” says ESMO presenter and co-principal investigator Dr. Pasi A. Jänne, director of the Lowe Center for Thoracic Oncology at Dana-Farber.

Jänne offered information exhibiting that the mix may gain advantage subgroups of sufferers with poor prognoses. For instance, the group of sufferers with central nervous system metastases who acquired osimertinib plus platinum–pemetrexed had median general survival of 40.9 months in comparison with 29.7 months for many who acquired osimertinib alone. 

About 10-15% of sufferers within the US and 50% of sufferers in Asia with NSCLC harbor epidermal progress issue receptor (EGFR) mutations of their tumors. The mutation fuels the expansion of the most cancers. 

The FLAURA2 trial examined including platinum–pemetrexed up-front together with osimertinib to stave off recurrence noticed with osimertinib monotherapy. Osimertinib is a 3rd era EGFR-tyrosine kinase inhibitor (EGFR-TKI).

The mixture was permitted by the U.S. Food and Drug Administration (FDA) in February 2024 based mostly on FLAURA2 outcomes exhibiting the mix lengthened development free survival in comparison with osimertinib alone. This last report of prolonged general survival with the mix underscores the advantage of the mix for sufferers, together with sufferers with a poor prognosis. 

“This is a very exciting development,” says Jänne. “These results show the benefits of a combination when started from the very beginning of treatment. I think there’s opportunity to use this as a platform to develop additional combination therapies that enhance efficacy from the start of treatment.”

Patients receiving the mix expertise further adversarial occasions related to the added chemotherapy. Side results embody nausea, vomiting, fatigue, and bone marrow toxicities and are most pronounced in the course of the first few months of remedy that features platinum chemotherapy however reduce throughout upkeep remedy with osimertinib and pemetrexed. 

“There are now multiple options for patients with newly diagnosed EGFR-mutant non-small cell lung cancer, including combination therapies and monotherapies, which is a wonderful thing,” says Jänne. “Patients have choices, and shared decision-making with patients will be essential to balance the greatest survival benefit against potential side effects.” 

Funding: This research was funded by AstraZeneca.