In patients with EGFR mutant L858R stage III NSCLC who are unresectable due to multistation N2 disease, would you consider upfront osimertinib over definitive intent CCRT?
If CCRT is pursued, would you move forward with durvalumab consolidation? Assume the patient with ECOG PS 0 and no co-morbidities. How might this change if ECOG 2?
Answer from: Medical Oncologist at Academic Institution
This is a very complex question that is common among our thoracic tumor board discussions. I'll answer the latter question first. In this case, I would not offer consolidative durvalumab.There are data that immune checkpoint inhibitors (ICIs) have minimal to no benefit in the metastatic setting base...
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Medical Oncologist at NYU Winthrop Hospital Great discussion
Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR LAURA ‘overwhelmingly’ positive for PF...
Answer from: Radiation Oncologist at Community Practice
While we await LAURA results, I wanted to point out this recent multi-institutional retrospective analysis by Nassar et al., PMID 38278303. This analysis of 136 concurrent chemo-RT patients with stage III NSCLC suggests longer PFS in those receiving consolidative osimertinib compared to durvalumab o...
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Radiation Oncologist at Vanderbilt-Ingram Cancer Center In regards to the LAURA trial -
Consolidati...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System I have news for you. The Osi arm gets indefinite t...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center Interesting approach.
Then, I would hope and expe...
Answer from: Radiation Oncologist at Academic Institution
I thoroughly enjoyed the above discussion points! One more obvious, but important point that I will add is that all patients eventually progress while on EGFR TKIs. These are not curative therapies. Patients who have EGFR-mutated Stages I-III, and even the oligometastatic Stage IV NSCLC, are potenti...
Answer from: Radiation Oncologist at Academic Institution
There have been multiple answers in regards to the role of consolidative osimeritinib as per above which, I think some shared decision-making and feasibility of approval is not unreasonable as above until we have LAURA results.In regards to the first question about considering induction osimeritinib...
Great discussion
LAURA ‘overwhelmingly’ positive for PF...