Osimertinib Plus Platinum-based Chemotherapy in Patients With EGFR-Mutated Advanced NSCLC Post-progression on First-Line Osimertinib: ORCHARD.
Jonathan W Goldman, Jonathan W Riess, Byoung Chul Cho et al.
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In 30 seconds
ORCHARD was a biomarker-directed, phase II platform study evaluating osimertinib plus platinum-based chemotherapy in patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC) after progression on first-line osimertinib. In this treatment module, 31 patients received osimertinib with platinum-doublet chemotherapy, followed by pemetrexed maintenance. Eight patients had a confirmed partial response, for an objective response rate of 26% (80% CI, 16-39). Median progression-free survival was 5.6 months (95% CI, 4.0-7.5). The investigators characterized clinical benefit as modest, with a manageable safety profile.
Key findings
- Eight of 31 patients had a confirmed partial response; objective response rate was 26% (80% CI, 16-39).
- Median progression-free survival was 5.6 months (95% CI, 4.0-7.5).
- Median overall survival was 10.9 months (95% CI, 8.5-15.0).
- Grade ≥ 3 adverse events occurred in 20 (65%) patients; adverse events led to discontinuation of any treatment in 7 (23%).
Why it matters
Progression after first-line osimertinib presents a treatment challenge in EGFR-mutated advanced NSCLC. This phase II module provides outcome and safety data for continuing osimertinib alongside platinum-based chemotherapy in that setting. The response and survival results offer a clinical benchmark, while the frequency of severe adverse events underscores the need to weigh potential benefit against treatment burden.
What to keep in mind
The treatment module included 31 patients and was a phase II study; the abstract does not report a comparator arm.