Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
Stephen Padilla, 4 days ago
A wearable, hermetically sealed high-precision vibration sensor enables simultaneous monitoring of multiple health factors associated with the cardiopulmonary system, including heart and respiratory rates, heart sounds, lung sounds, and body motion and position of an individual, a study shows.
Roshini Claire Anthony, 03 Feb 2020

The emergence of a novel coronavirus (preliminarily referred to as 2019-nCoV) has taken hold of public attention in the last month. MIMS Doctor speaks to Professor Dale Fisher, a senior consultant at the Division of Infectious Diseases, National University Hospital, Singapore, to get a better picture of the situation and steps being undertaken in Singapore to prevent spread of the virus.

Tristan Manalac, 14 Feb 2020
The use of e-cigarettes with flavoured juices for weight-related reasons appears to be common among adolescents, according to a new study.

Osimertinib extends PFS vs SOC in first-line treatment of advanced NSCLC in FLAURA Asian subset

Roshini Claire Anthony
24 Nov 2017
Professor Byoung Chul Cho

Osimertinib further extends progression-free survival (PFS) over standard-of-care (SOC) first-line therapy in Asian patients with advanced or metastatic epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), according to the Asian subset analysis of the phase III FLAURA* trial.

In this subset of 322 Asian participants, of whom 46 were Chinese, 120 Japanese, and 156 from other parts of Asia, patients with locally advanced or metastatic NSCLC (median age 64 years) with WHO performance status 0–1 and harbouring EGFR Ex19del or L858R were randomized to receive osimertinib (80 mg QD) or SOC treatment (erlotinib [150 mg QD] or gefitinib [250 mg QD]).

Patients on osimertinib demonstrated longer PFS compared with patients on SOC (median, 16.5 vs 11.0 months; hazard ratio [HR], 0.54, 95 percent confidence interval, 0.41–0.72; p<0.0001). [ESMO Asia 2017, abstract LBA6_PR]

While the overall response rate was comparable between patients in the osimertinib and SOC arms (80 percent vs 75 percent; odds ratio [OR], 1.33; p=0.2918), the duration of response among patients on osimertinib was double that of those on SOC (median, 18 vs 9 months; OR, 2.19; p=0.0002).

In terms of overall survival (OS), data is yet immature, though results point to “an interesting trend towards improved OS with osimertinib compared with SOC” (HR, 0.65; p=0.0609), said lead author Professor Byoung Chul Cho from the Yonsei Cancer Center in Seoul, Korea, who presented the findings of the Asian subset at ESMO Asia 2017.

Fewer patients on osimertinib than SOC experienced grade ≥3 adverse events (AEs; 40 percent vs 48 percent) or discontinued treatment due to any AEs (15 percent vs 21 percent).

Dermatitis acneiform, and AST and ALT increases occurred in a smaller proportion of patients on osimertinib compared with SOC (30 percent vs 53 percent, 12 percent vs 36 percent, and 7 percent vs 36 percent, respectively), while more patients on osimertinib experienced QT prolongation (15 percent vs 5 percent) and interstitial lung disease (6 percent vs 2 percent).  

Osimertinib is currently approved and recommended for use in patients with T790M-positive NSCLC following treatment with an EGFR tyrosine kinase inhibitor (TKI). [Ann Oncol 2016;27(Suppl 5):v1-v27]

“As in the overall trial population, osimertinib provided a significant [PFS] benefit in Asian patients with EGFR-mutated NSCLC. Asian patients had similar toxicities with osimertinib as the overall FLAURA population,” said Cho.

“Data from this analysis support osimertinib as a new [SOC] for first-line therapy in Asian patients with EGFR-mutated advanced NSCLC,” he said.

“There is an ongoing debate as to whether Asian and non-Asian patients with EGFR mutations have distinct responses to EGFR-TKIs. This might be due to variations in clinical practice rather than biology,” said Professor James Yang from the National Taiwan University College of Medicine in Taipei, Taiwan, who called for further study to examine this issue as well as to identify the reasons behind treatment discontinuation.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
Stephen Padilla, 4 days ago
A wearable, hermetically sealed high-precision vibration sensor enables simultaneous monitoring of multiple health factors associated with the cardiopulmonary system, including heart and respiratory rates, heart sounds, lung sounds, and body motion and position of an individual, a study shows.
Roshini Claire Anthony, 03 Feb 2020

The emergence of a novel coronavirus (preliminarily referred to as 2019-nCoV) has taken hold of public attention in the last month. MIMS Doctor speaks to Professor Dale Fisher, a senior consultant at the Division of Infectious Diseases, National University Hospital, Singapore, to get a better picture of the situation and steps being undertaken in Singapore to prevent spread of the virus.

Tristan Manalac, 14 Feb 2020
The use of e-cigarettes with flavoured juices for weight-related reasons appears to be common among adolescents, according to a new study.