Topics:
Lung Cancer • Radiation Oncology • Thoracic Malignancies • Medical Oncology • Journal Club ft. NEJM publications
Should we consider radiation therapy for patients with N2 EGFRm NSCLC who will receive osimertinib, though RT was excluded on ADAURA?
Conversely: In a patient with N2 EGFR+ NSCLC receiving radiation, would you still consider use of osimertinib?
Answer from: Medical Oncologist at Academic Institution
For an EGFR-mutant N2 disease, we favor adjuvant chemotherapy (OS benefit) and/or adjuvant TKI based on ADAURA trial (DFS survival). The only prospective data regarding the use of adjuvant radiotherapy comes from a phase III trial, Lung Adjuvant Radiotherapy Trial (Lung-ART), where patients were ran...
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Answer from: Medical Oncologist at Academic Institution
Regardless of ADAURA or osimertinib, this could be a very easy question to answer given the LungART trial data presented recently at ESMO 2020 and the fact that there has never been a randomized trial of post-operative radiation therapy (PORT) that has demonstrated an overall survival benefit in pat...
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Radiation Oncologist at Mon Health
Thank you. Stay safe, my friend. -Fred
Thank you. Stay safe, my friend. -Fred
Answer from: Medical Oncologist at Academic Institution
No, the trial was positive without radiation. The recent Lung ART trial did not show any benefit for post-operative radiation, so I would avoid that.
Answer from: Medical Oncologist at Academic Institution
The benefit of adjuvant radiation for N2 disease has not been proven with the same level of evidence as the question of adjuvant chemotherapy.
I may be less likely to pursue adjuvant radiation in a patient to get adjuvant osimertinib. However, if an N2+ patient is receiving radiation, I would...