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ASCO 2026 | FLAME: osimertinib plus chemotherapy in persistent ctDNA EGFR-mutant NSCLC
Erika Ruiz-Garcia, MD, Instituto Nacional de Cancerologia, Mexico City, Mexico, presents findings from the Phase II FLAME study (NCT04769388) of osimertinib plus chemotherapy versus osimertinib monotherapy in patients with non-small cell lung cancer (NSCLC) harboring persistent circulating tumor DNA (ctDNA) EGFR mutations after first-line osimertinib. While the study has methodological limitations, treatment pressure may contribute to tumor evolution and the persistence of EGFR mutations, highlighting the need for more comprehensive testing to better understand this phenomenon. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
This kind of trials are very interesting because we try to find out how new tools like the ctDNA can help to escalate treatments for those patients that persist with mutations besides the fact that they got a specific treatment for that. So I think that idea is great. The study has some methodological issues, and that’s why we cannot consider the results as changing practice...
This kind of trials are very interesting because we try to find out how new tools like the ctDNA can help to escalate treatments for those patients that persist with mutations besides the fact that they got a specific treatment for that. So I think that idea is great. The study has some methodological issues, and that’s why we cannot consider the results as changing practice. And also, we find out that the persistence of those kinds of mutations might be related with tumor evolution because of the treatment pressure. But besides that, I think that the panel that was performed to know what kind of persistence was present, it was not big enough. So a suggestion is that it is needed to have a more comprehensive test, trying to know what’s going on with this kind of pressure that the treatment does on the EGFR mutations.
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