Currently in Spain, approximately, between 10 and 12 percent of lung cancers present positive mutation of EGFR and especially is more frequent in nonsmoking population. In these cases, in addition, a high percentage of patients presents an important systemic involvement. It is precisely for this subgroup of population for which a new treatment has been approved: osimertinib, marketed as Tagrisso by Astrazeneca.
Specifically osimertinib is an irreversible third-generation EGFR-TKI, designed to inhibit mutations that sensitize EGFR activity as well as those that confer resistance. It has been approved in Spain as a monotherapy for the first line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of the epidermal growth factor receptor (EGFR), thanks to the results of the FLAURA trial.
In the words of Luis Paz-Ares, Head of Service of the University Hospital 12 de Octubre, “the FLAURA trial shows that if we use osimertinib as initial treatment, the appearance of resistance is substantially delayed and, therefore, a control of this type of lung cancer longer since it reduces, to more than half, the risk of progression throughout the period of the study in relation to the inhibitors of 1st generation “.
Similarly, osimertinib has shown efficacy in all relevant subgroups of patients studied. In addition, according to Paz Ares, “the safety profile of osimertinib is favorable and consistent with the inhibition of EGFR. The rate of adverse effects grade 3-4 decreased from 45 to 34 percent. ” For this reason, the expert concludes that “from the point of life of benefit / risk, it is undoubtedly a new reference treatment, by globally increasing the benefit in a relevant way, and presenting an adequate safety profile. Based on these facts, the drug could be of choice for many patients, while we continue to investigate what is the optimal sequence of treatment for each patient. “