Superb discussion by @LeXiuning at #ESMO26 on ctDNA-guided treatment selection in EGFRm NSCLC.
Key message: Early ctDNA clearance is prognostic, but NOT predictive of benefit from adding chemotherapy.
Even patients achieving clearance derive substantial PFS benefit from osimertinib + chemo (HR 0.51).
Can we safely spare chemotherapy in selected patients? Promising hypothesis, but not yet proven. If ctDNA is not detectable upfront (20% pts) then 30
Months mPFS with Osi only!
#ESMOAmbassador #LungCancer
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FLAURA2: Analysis of on-treatment plasma EGFRm dynamics and associated clinical outcomes in patients (pts) with EGFRm advanced NSCLC treated with first-line (1L) osimertinib (osi) ± platinum–pemetrexed (plat–pem)
https://esmocongress.esmo.orgPACE-LUNG: A multicenter, single-arm, phase II clinical trial evaluating the efficacy of additional chemotherapy for patients with EGFRm NSCLC with the continued presence of plasma ctDNA EGFRm at week 3 after start of osimertinib first-line
https://esmocongress.esmo.orgSource: Alfredo Addeo MD · x.com