🧬 Early ctDNA clearance tells us a lot about prognosis — but not necessarily which treatment to choose.
@OncoAlert @myESMO
At #ESMO26, an exploratory FLAURA2 analysis evaluated plasma EGFRm dynamics during first-line osimertinib ± platinum–pemetrexed in advanced EGFR-mutant #NSCLC.
📊 Week 6 EGFRm clearance
🔹 88% with osimertinib + chemotherapy
🔹 89% with osimertinib alone
Yet the prognostic signal was clear:
➡️ In patients with Week 6 clearance, combination therapy improved PFS: HR 0.52
➡️ In those without clearance, PFS also favored combination therapy: HR 0.40
OS showed the same directional pattern:
🔹 cleared: HR 0.73
🔹 not cleared: HR 0.50
🎯 Why this matters: ctDNA clearance was prognostic, not predictive.
For me, that distinction is crucial. A biomarker can tell us who is doing better or worse without necessarily telling us who should receive a different treatment.
FLAURA2 reinforces that osimertinib + platinum–pemetrexed improved outcomes regardless of early plasma EGFRm clearance.
The next step is finding biomarkers that do more than describe risk — they must actually change the therapeutic decision.
Excellent work from @dplanchard and the FLAURA2 investigators.
Pinging @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