🧬 早期 ctDNA 清除能告诉我们很多有关预后的信息——但不一定能告诉我们该选择哪种治疗。
@OncoAlert @myESMO
在 #ESMO26，一项探索性 FLAURA2 分析评估了晚期 EGFR 突变型 #NSCLC 患者一线接受 osimertinib ± 铂类–pemetrexed 治疗期间的血浆 EGFRm 动态变化。
📊 第 6 周 EGFRm 清除率
🔹 osimertinib + 化疗组为 88%
🔹 osimertinib 单药组为 89%
但其预后信号非常明确：
➡️ 在第 6 周达到清除的患者中，联合治疗改善了 PFS：HR 0.52
➡️ 在未达到清除的患者中，PFS 也更倾向于联合治疗：HR 0.40
OS 呈现出相同的方向性趋势：
🔹 已清除：HR 0.73
🔹 未清除：HR 0.50
🎯 为何重要：ctDNA 清除是预后性指标，而非预测性指标。
对我而言，这一区别至关重要。生物标志物可以告诉我们谁的治疗效果更好或更差，但不一定能告诉我们谁应该接受不同的治疗。
FLAURA2 进一步证实，无论早期血浆 EGFRm 是否清除，osimertinib + 铂类–pemetrexed 都能改善结局。
下一步是寻找不仅能描述风险，而且能真正改变治疗决策的生物标志物。
@dplanchard 和 FLAURA2 研究团队的出色工作。
特别感谢 @christine_lovly @GlopesMd @DrSanjayPopat @StephenVLiu @jillfeldman4 @CharuAggarwalMD @peters_solange @BRicciutiMD @VanitaNoronha @JordiRemon
#OncoAlert #ESMO26 #LungCancer #EGFR #ctDNA #PrecisionOncology
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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.orgOncoAlert 4Sight Abstracts to be Presented at #ESMO26 FLAURA2: Analysis of On-Treatment Plasma EGFRm Dynamics and Associated Clinical Outcomes in Patients With EGFRm Advanced NSCLC Treated With First-Line Osimertinib ± Platinum–Pemetrexed @dplanchard 🫁 Exploratory ctDNA analysis of phase III FLAURA2: plasma EGFRm clearance (ddPCR) at Weeks 1, 2, 3 and 6 with first-line osimertinib ± platinum–pemetrexed in EGFRm advanced NSCLC. ➡️ Week 6 clearance: 88% vs 89% ➡️ Week 6 cleared: PFS HR 0.52 (0.36–0.76); not cleared: PFS HR 0.40 (0.16–0.97) ➡️ Week 6 OS HR 0.73 (cleared) and 0.50 (not cleared) ✅ Clearance was prognostic but not predictive; osimertinib + platinum–pemetrexed was superior to osimertinib regardless of clearance status. #NSCLC 🎙️ David Planchard 👥 Pasi Jänne · Ying Cheng · James Yang · Noriko Yanagitani · Sang-We Kim · Shunichi Sugawara · Yan Yu · Yun Fan · Sarayut Geater · Konstantin Laktionov · Chee Lee · Natalia Valdiviezo · Samreen Ahmed · Jean-Marc Maurel · Igor Andrasina · Jonathan Goldman · Dana Ghiorghiu · Yuri Rukazenkov · Alex Todd · Kunihiko Kobayashi (4Sight Made from Abstracts publicly available at the ESMO website) Pinging our faculty @christine_lovly, @GlopesMd, @DrSanjayPopat, @StephenVLiu, @jillfeldman4, @UOzkerim, @DrMirallas, @MartinReck2 , @bmassutis @UmbertoMalapel1 , @CharuAggarwalMD @peters_solange, @HenningWillers, @HHorinouchi, @BRicciutiMD, @PercyLeeMD, @bensolomon1, @Latinamd, @DrJNaidoo, @barlesi, @VanitaNoronha, @ChristianRolfo @Tony_Calles @s_couraud @marinagarassino @g_mountzios @BairdAM @barlesi @JFreemanDaily @Piuchagarrido @PercyLeeMD @bensolomon1 @VanitaNoronha @alexdrilon @JordiRemon @JulienMazieres @TerriConneran @HenningWillers在 X 查看被引用的帖子
来源：Dra. María Natalia Gandur Quiroga · x.com