The FLAURA2 trial evaluated whether adding platinum-based chemotherapy (pemetrexed + cisplatin or carboplatin) to osimertinib improves outcomes in treatment-naïve EGFR-mutant advanced NSCLC. The study demonstrated a significant improvement in progression-free survival (PFS) with the combination.
Patients receiving osimertinib plus chemotherapy achieved a median PFS of 25.5 months versus 16.7 months with osimertinib alone (HR 0.62; 95% CI, 0.49–0.79; P < 0.001). Objective response rates were also higher (83% vs. 76%), and duration of response was notably prolonged (24.0 vs. 15.3 months).
Toxicity was increased in the combination arm. Common toxicities included expected side effects from the addition of chemotherapy such as cytopenias and gastrointestinal effects. Despite the added toxicity, the combination may be valuable for patients with high disease burden or CNS involvement especially if the study ultimately shows overall survival advantage for the combination treatment.
This trial reinforces the strategy of intensifying first-line EGFR therapy and raises key questions about balancing efficacy with tolerability.
