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Topics:
Radiation Oncology • Thoracic Malignancies • Medical Oncology • Non-small cell lung cancer • EGFR+
How do you counsel patients with Stage IIIA EGFR+ lung cancer regarding treatment intent with concurrent chemoRT + consolidative systemic therapy?
With low #s of patients on the durvalumab PACIFIC trial with EGFR mutated disease, and LAURA trial design of osimertinib until progression, should we forgo "curative" intent? Would there be consideration of time limited osimertinib?
Answer from: Medical Oncologist at Academic Institution
I think one of the crucial take-home points from the LAURA clinical trial (Lu et al., PMID 38828946) is how often we (the medical oncology community) tell patients we are treating them with "curative intent" but ignore the incredibly high relapse risk among patients with EGFR mutant NSCLC with stage...
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Answer from: Radiation Oncologist at Community Practice
Side note, this topic of adjuvant osi after CRT was added to NCCN this week (category 1 for stage III; category 2A for stage II). I'm not an expert on insurance approval of drugs for XYZ indications but I am of the peripheral understanding that the NCCN inclusion may allow some coverage. It is not F...
Answer from: Radiation Oncologist at Academic Institution
The tough answer is that Osi after chemoRT improves PFS without significant OS benefit based on current data. Thus, is there any advantage of doing consolidative indefinite Osi vs waiting for progression (I agree that Durva consolidation does not do great in EGFR+ patients) and treating with Osi at ...