Tony Mok, MD, FASCO
“IN 2008, I presented the IPASS results. FLAURA has beaten me to the ground. The results exceeded expectations, and FLAURA is undoubtedly a positive study,” stated formal discussant Professor Tony Mok, MD, FASCO, Chair of Department of Clinical Oncology, the Chinese University of Hong Kong. “It is rightful to claim osimertinib as a standard of care for EGFR-mutated non–small cell lung cancer (NSCLC). This drug has less skin toxicity and less liver enzyme elevation than the other EGFR tyrosine kinase inhibitor.”
Dr. Mok continued: “I have confidence that patients with CNS metastasis at presentation would benefit the most, considering osimertinib’s higher CNS penetration, but the optimal sequence for overall survival is still controversial.” He acknowledged that osimertinib has an improved side-effect profile compared with second-generation EGFR tyrosine kinase inhibitors.
HOWEVER, DR. MOK questioned the wisdom of changing practice based on immature overall survival data in FLAURA. “Overall survival data are immature, and the final total number of patients able to cross over from standard of care to osimertinib is uncertain. The other uncertainty is the mechanism and management of osimertinib resistance upon disease progression. Thus, the real paradigm change will have to wait until the eventual maturity of the data,” Dr. Mok told listeners.
“Should the winner take all? Only for love. For EGFR tyrosine kinase inhibitors, please wait for mature data,” he added. ■
DISCLOSURE: Dr. Mok reported no conflicts of interest.
“Osimertinib should be considered a new standard of care for first-line therapy of EGFR mutation–positive non–small cell lung cancer.”— Suresh Ramalingam, MD
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