The Role of Adjuvant Chemotherapy before Osimertinib in Epidermal Growth Factor Receptor Mutant Resected Non-Small Cell Lung Cancer and Communicating It to Patients
Abstract
:1. Introduction
2. Outcomes of Adjuvant Platin-Based Chemotherapy
2.1. Efficacy
2.2. Safety and Outcomes in Elderly Patients
3. Shared Decision Making When Administering Adjuvant Chemotherapy to Patients Whose Tumors Do Not Harbour EGFR Mutation
4. Outcomes of Adjuvant Osimertinib
4.1. Efficacy
4.2. Safety Profile of Adjuvant Osimertinib, and Paradigm Shift from Toxic Chemotherapy
4.3. Adjuvant Chemotherapy Use before Osimertinib
4.4. Summary of ADAURA Trial Outcomes
5. Shared Decision Making When Administering Adjuvant Chemotherapy to Patients Whose Tumors Harbour EGFR Mutation
6. Adjuvant Chemotherapy in ALK-Rearranged Resected NSCLC
7. Adjuvant Chemotherapy in the New Era of Adjuvant Immunotherapy
8. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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ARR | NNT | SAE | |
---|---|---|---|
Adjuvant cisplatin-based chemotherapy in EGFR WT NSCLC | 4 | 25 | 80% [4] (cisplatin-vinorelbine) |
Adjuvant osimertinib in EGFR-mutated NSCLC | 12 | 8 | 23% [9] |
Adjuvant cisplatin-based chemotherapy added to osimertinib in EGFR-mutated NSCLC | 4 or less? | 25 or more? | 80% [4] (cisplatin-vinorelbine) |
Disease-Free Survival Advantage versus Placebo or Chemotherapy (Hazard Ratio) | Serious Adverse Events | |
---|---|---|
Atezolizumab after chemotherapy versus placebo PDL-1 > 1% [23,24] | 0.66 (95% CI 0.50–0.88) | 11% |
Atezolizumab after chemotherapy versus placebo PDL-1 > 50% [23,24] | 0.43 (95% CI 0.27–0.68) | 11% |
Pembrolizumab after chemotherapy or alone versus placebo Any PDL-1 expression [25] | 0.76 (95% CI 0.27–0.91) | 24% |
Pembrolizumab after chemotherapy or alone versus placebo PDL-1 > 50% [25] | 0.82 (95% CI 0.57–1.18) | 24% |
Alectinib versus chemotherapy [22] | 0.24 (95% CI 0.13–0.45) | 13% |
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Maione, P.; Salvi, R.; Gridelli, C. The Role of Adjuvant Chemotherapy before Osimertinib in Epidermal Growth Factor Receptor Mutant Resected Non-Small Cell Lung Cancer and Communicating It to Patients. Curr. Oncol. 2024, 31, 987-997. https://doi.org/10.3390/curroncol31020074
Maione P, Salvi R, Gridelli C. The Role of Adjuvant Chemotherapy before Osimertinib in Epidermal Growth Factor Receptor Mutant Resected Non-Small Cell Lung Cancer and Communicating It to Patients. Current Oncology. 2024; 31(2):987-997. https://doi.org/10.3390/curroncol31020074
Chicago/Turabian StyleMaione, Paolo, Rosario Salvi, and Cesare Gridelli. 2024. "The Role of Adjuvant Chemotherapy before Osimertinib in Epidermal Growth Factor Receptor Mutant Resected Non-Small Cell Lung Cancer and Communicating It to Patients" Current Oncology 31, no. 2: 987-997. https://doi.org/10.3390/curroncol31020074