A plain language review of results from the LAURA study: osimertinib after chemoradiotherapy for patients with EGFR-mutated non-small cell lung cancer that cannot be removed by surgery

Abstract

Plain Language Summary: What is this summary about? We review current standard treatment for patients with non-small cell lung cancer (NSCLC) that has spread to nearby tissues and/or nearby parts of the immune system called lymph nodes (stage III) that could not be removed by surgery (unresectable), and had an EGFR mutation. The epidermal growth factor receptor (known as EGFR) is a type of protein present on the surface of some cells, which controls how cells grow and divide. Mutations in the EGFR gene can result in the development of lung cancer. We include a summary of results from the LAURA study, which evaluated osimertinib treatment for these patients. Osimertinib is a medicine that blocks the activity of mutated EGFR protein on cancer cells, causing cancer cell death and tumor shrinkage. The LAURA study focused on unresectable stage III EGFR-mutated NSCLC treated with chemoradiotherapy (a combination of a medicine and radiation therapy to kill cancer cells and shrink the tumor); if the cancer did not grow or spread during or after this treatment, patients were enrolled in LAURA and randomly assigned to receive osimertinib or placebo. What are the key takeaways? Osimertinib significantly increased the time that patients lived without the cancer growing or spreading (called progression-free survival). Patients who received osimertinib had the median progression-free survival extended by 33.6 months, compared with placebo. The median timepoint of progression-free survival is a type of average at which half of the patients were alive without the cancer growing or spreading. The most common side effects were lung inflammation from radiotherapy (radiation pneumonitis), diarrhea and rash, consistent with what we already know about osimertinib and chemoradiotherapy. What were the main conclusions reported by the researchers? Findings from the LAURA study led to regulatory approvals and guideline recommendations for using osimertinib to treat patients with unresectable stage III EGFR-mutated NSCLC, whose cancer has not grown or spread (progressed) during or after chemoradiotherapy. Clinical trial number: NCT03521154.