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WCLC 2025 | Osimertinib and chemotherapy as the standard of care in EGFRm NSCLC
Samreen Ahmed, FRCP, MD, MBBS, MSc, University Hospitals of Leicester NHS Trust, Leicester, UK, emphasizes the importance of combining chemotherapy with osimertinib as the standard of care (SOC) for patients with EGFR-mutant non-small cell lung cancer (NSCLC), particularly for those with CNS disease. While osimertinib alone may be sufficient for some patients, the combination of chemotherapy and osimertinib offers better outcomes. This recommendation is supported by the COMPEL study (NCT04765059), which showed that continuing osimertinib with chemotherapy yields better outcomes than switching to chemotherapy alone, both in CNS and non-CNS disease. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
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Transcript
Yeah, I think now with the overall survival data for the whole population, for the whole intention to treat population, I think as clinicians, we should definitely be recommending the combination. So a combination of chemotherapy and osimertinib and not just osimertinib alone. Obviously, for some patients, there will be some pertinent reasons why they don’t want chemotherapy or they’re not able to have it for whatever comorbidity reason...
Yeah, I think now with the overall survival data for the whole population, for the whole intention to treat population, I think as clinicians, we should definitely be recommending the combination. So a combination of chemotherapy and osimertinib and not just osimertinib alone. Obviously, for some patients, there will be some pertinent reasons why they don’t want chemotherapy or they’re not able to have it for whatever comorbidity reason. And therefore, I think the combination perhaps could be reduced to just osimertinib alone. But our standard of care should now be chemotherapy and osimertinib. Now, there was another very important academic study called COMPEL presented today. And this was actually prior to FLAURA 2 standard of care now reporting. So at that time, we were only giving single agent osimertinib. When patients progressed, this study randomized to continuing osimertinib, adding in chemotherapy, or stopping osimertinib and giving them a switch to chemotherapy. It looks like as if the outcomes are much better if you continue osimertinib with chemotherapy rather than just switching to chemotherapy. That’s both in CNS disease, which is really the unmet need in this area, but also in non-CNS progression.
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