Two Onc Docs ASCO 2024 Plenary: LAURA Trial in Unresectable Stage III EGFRm NSCLC
Jun 10, 2024
The podcast dives into the groundbreaking LAURA trial, showcasing how osimertinib post-chemoradiotherapy benefits patients with unresectable stage III EGFR-mutated NSCLC. It highlights advancements in staging and treatment, particularly the significance of the PACIFIC trial. Key findings reveal improved survival rates for patients on maintenance therapy. Discussions also cover the challenges of toxicity and indefinite treatment amidst unclear biomarkers, alongside the trial’s superiority over previous standards, reshaping treatment strategies for lung cancer.
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Stage 3 NSCLC Definition and Staging
- Stage three non-small cell lung cancer involves large tumors and/or positive lymph nodes with complex nodal involvement.
- Proper staging requires PET scan, brain MRI, and pathologic lymph node evaluation to rule out metastatic disease.
PACIFIC Trial Established Standard
- Chemoradiation followed by durvalumab was the previous standard for unresectable stage 3 NSCLC.
- Durvalumab improved both progression-free and overall survival in that setting.
EGFR Mutation Impacts Treatment Choice
- EGFR-mutated NSCLC patients do not respond well to immunotherapy.
- Osimertinib presents a promising maintenance option post-chemoradiation in this subgroup.