SESSION IN PERSPECTIVE

Amivantamab plus lazertinib as a first-line treatment for patients with EGFR-mutant advanced NSCLC

Since the publication of the ADAURA trial, osimertinib has been the undisputed standard of care first line treatment for patients with advanced, EGFR-mutant non-small cell lung cancer (NSCLC). Despite a high initial response rate with this agent, most patients treated with osimertinib will eventually relapse. During the 2023 annual meeting of the European Society of Medical Oncology (ESMO), results of the randomized, phase 3 MARIPOSA trial demonstrated that a combination of amivantamab and lazertinib was associated with a better progression-free survival (PFS) and more durable responses than osimertinib in previously untreated advanced, EGFR-mutant NSCLC patients. With these findings, amivantamab plus lazertinib challenges osimertinib as the standard of care in this setting.

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Reflex testing for mutations in patients with early-stage non-small cell lung cancer: practical implications from ADAURA

SUMMARY

Targeted therapies against activating EGFR mutations stood at the cradle of the personalised treatment revolution for patients with advanced non-small cell lung cancer (NSCLC). Since then, molecular testing for EGFR mutations and many other oncogenic drivers has become part of the routine diagnostic work-up for patients with advanced NSCLC. Recently, the phase III ADAURA trial showed that the EGFR TKI osimertinib also induces a significant overall survival benefit in the adjuvant treatment of patients with early-stage NSCLC, instigating a new wave in this personalised treatment revolution. Based on these results, routine EGFR mutation testing should be expanded to also include early-stage NSCLC patients. In this, a reflex testing strategy is preferred as it reduces turnaround times and standardises the ordering of biomarker tests to ensure that more patients are being tested.

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