FLAME: Osimertinib Plus Chemotherapy Improves PFS in ctDNA-Persistent NSCLC
Osimertinib plus carboplatin/pemetrexed significantly improves progression‑free survival versus osimertinib monotherapy in EGFR‑mutant non‑small cell lung cancer patients with persistent plasma ctDNA EGFR mutation at week 3 of first‑line therapy.
A phase 2, randomized FLAME trial evaluated osimertinib plus carboplatin/pemetrexed versus osimertinib alone in 80 patients with EGFR‑mutant NSCLC who remained ctDNA‑persistent at 3 weeks after initiation of first‑line osimertinib. The combination arm achieved a median PFS of 23.1 months versus 12.7 months in the monotherapy arm (HR 0.54, P = .028) and a higher ORR (50% vs 35%). Safety was consistent with known profiles of the agents. The study supports ctDNA‑guided early intensification for this poor‑prognosis population.
This study demonstrates that ctDNA persistence at a short lead‑time after initiating first‑line EGFR TKI can identify patients who benefit from early treatment intensification, enabling more personalized care and potentially improving outcomes in advanced EGFR‑mutant NSCLC.
Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.
Related signals
- Telisotuzumab Vedotin + Osimertinib for Non‑Small Cell Lung Cancer
- Ramucirumab plus erlotinib in patients with untreated, EGFR‑mutated, advanced non‑small‑cell lung cancer (RELAY): a randomised, double‑blind, placebo‑controlled, phase 3 trial
- Recent advancements in lung cancer research: a narrative review
- Advances in Non-Small Cell Lung Cancer: Current Insights and Future Directions
- Structured proxy features for multimodal NSCLC survival prediction from pretreatment CT