Evoluzione delle strategie di trattamento sequenziale nel NSCLC con mutazione di EGFR: il punto
Giulia Pasquini
Azienda Ospedaliero-Universitaria Pisana Università di Pisa
Perugia, 5 Luglio 2019
Dacomitinib
Osimertinib Gefitinib
Afatinib 1° Generation
2° Generation
3° Generation
Erlotinib
EGFR TKIs
Background: EGFR TKIs
Background EGFR TKI
First-Line Treatment of EGFRmut NSCLC EGFR TKIs vs Chemotherapy
EGFR TKI vs Chemotherapy
Acquired resistance to oncogene driven NSCLC
Acquired resistance to TKI
Acquired resistance to 1st/2nd generation EGFR TKIs*
Acquired resistance to first and second generation TKIs
First line Therapy: Key Recent Trials
PFS: Blinded Independent Review <br />(ITT population)
ARCHER-PFS (primary endpoint)
ARCHER 1050: Overall Survival
ARCHER-OS
Primary Endpoint: PFS by Investigator
FLAURA-PFS (primary endpoint)
Overall Survival Interim Analysis
FLAURA-OS interim analysis
FLAURA and ARCHER 1050
FLAURA & ARCHER 1050
First-Line Therapy: Key Recent Trials
First line Therapy: Key Recent Trials
Strategy Inversion..
From tailored therapy to….combination Strategy
From less is more….…to more is better!
NEJ009: Upfront chemotherapy + TKI
NEJ009: Upfront chemotherapy+TKI
Gef vs Gef + C
Gef vs Gef+C
Slide 25
Gef vs Gef+C
First-Line Therapy: Key Recent Trials
First line Therapy: Key Recent Trials
RCTs of Erlotinib vs. Erlotinib/Bev
RCTs of Erlotinib vs Erlotinib/Bev
RELAY: Study Design1,2
RELAY
Slide 8
RELAY
Slide 12
RELAY
Optimal sequencing…
Optimal sequencing..for the data available now..
Available sequencing..for now..
Available sequencing..for now..
Acquired Resistance to Osimertinib
The future: Acquired resistance to 1L Osimertinib
Acquired Resistance: #ASCO19 and Next Steps
Acquired resistance: ASCO 2019 and next Steps
1st Line Setting: #ASCO19 and Next Steps
First line Setting: ASCO 2019 and next steps
50%
Grazie per l’attenzione!
50%
g.pasquini988@gmail.com