New study results reinforce TAGRISSO® (osimertinib) as the backbone therapy for EGFR-mutated lung cancer across stages and settings
AstraZeneca presented new study results at ELCC 2025 reinforcing TAGRISSO® (osimertinib) as a cornerstone therapy for EGFR-mutated non-small cell lung cancer (NSCLC). Key findings include:
The LAURA Phase III trial showed improved overall survival trend with TAGRISSO vs placebo in unresectable Stage III setting (58.8 vs 54.1 months). The SAVANNAH Phase II trial demonstrated 56% response rate combining TAGRISSO with savolitinib in patients with high MET levels after disease progression. The ORCHARD trial showed promising results combining TAGRISSO with datopotamab deruxtecan-dlnk, achieving up to 43% response rate.
The FLAURA2 trial analysis revealed progression-free survival of over two years when combining TAGRISSO with chemotherapy. Safety profiles across all trials were consistent with established data, though monitoring is required for potential serious side effects including interstitial lung disease, QT interval prolongation, and cardiomyopathy.
AstraZeneca ha presentato nuovi risultati di studio all'ELCC 2025, rafforzando TAGRISSO® (osimertinib) come terapia fondamentale per il carcinoma polmonare non a piccole cellule (NSCLC) con mutazione EGFR. I risultati chiave includono:
Il trial di fase III LAURA ha mostrato una tendenza al miglioramento della sopravvivenza globale con TAGRISSO rispetto al placebo in un contesto di Stadio III non resezionabile (58,8 vs 54,1 mesi). Il trial di fase II SAVANNAH ha dimostrato un tasso di risposta del 56% combinando TAGRISSO con savolitinib in pazienti con alti livelli di MET dopo progressione della malattia. Il trial ORCHARD ha mostrato risultati promettenti combinando TAGRISSO con datopotamab deruxtecan-dlnk, raggiungendo fino al 43% di tasso di risposta.
L'analisi del trial FLAURA2 ha rivelato una sopravvivenza libera da progressione di oltre due anni quando si combina TAGRISSO con chemioterapia. I profili di sicurezza in tutti i trial sono stati coerenti con i dati consolidati, sebbene sia necessario monitorare potenziali effetti collaterali gravi, tra cui malattia polmonare interstiziale, prolungamento dell'intervallo QT e cardiomiopatia.
AstraZeneca presentó nuevos resultados de estudio en el ELCC 2025, reafirmando a TAGRISSO® (osimertinib) como una terapia fundamental para el cáncer de pulmón no microcítico (NSCLC) con mutación EGFR. Los hallazgos clave incluyen:
El ensayo de fase III LAURA mostró una tendencia de mejora en la supervivencia global con TAGRISSO frente al placebo en un contexto de etapa III no resecable (58,8 vs 54,1 meses). El ensayo de fase II SAVANNAH demostró una tasa de respuesta del 56% combinando TAGRISSO con savolitinib en pacientes con altos niveles de MET tras la progresión de la enfermedad. El ensayo ORCHARD mostró resultados prometedores al combinar TAGRISSO con datopotamab deruxtecan-dlnk, alcanzando hasta un 43% de tasa de respuesta.
El análisis del ensayo FLAURA2 reveló una supervivencia libre de progresión de más de dos años al combinar TAGRISSO con quimioterapia. Los perfiles de seguridad en todos los ensayos fueron consistentes con los datos establecidos, aunque se requiere monitoreo para posibles efectos secundarios graves, incluidos enfermedad pulmonar intersticial, prolongación del intervalo QT y miocardiopatía.
AstraZeneca는 ELCC 2025에서 새로운 연구 결과를 발표하며 TAGRISSO® (오시머티닙)를 EGFR 변이가 있는 비소세포 폐암 (NSCLC)의 핵심 치료제로 강화했습니다. 주요 발견 사항은 다음과 같습니다:
LAURA 3상 시험은 절제 불가능한 3기에서 TAGRISSO와 위약 간의 전체 생존 기간 개선 경향을 보여주었습니다 (58.8개월 대 54.1개월). SAVANNAH 2상 시험은 질병 진행 후 높은 MET 수치를 가진 환자에서 TAGRISSO와 사볼리티닙을 결합했을 때 56%의 반응률을 입증했습니다. ORCHARD 시험은 TAGRISSO와 다토포타맙 데룩스테칸-dlnk을 결합했을 때 최대 43%의 반응률을 달성하며 유망한 결과를 보여주었습니다.
FLAURA2 시험 분석에서는 TAGRISSO와 화학요법을 결합했을 때 2년 이상의 무진행 생존 기간이 나타났습니다. 모든 시험에서의 안전성 프로파일은 확립된 데이터와 일치했지만, 간질성 폐질환, QT 간격 연장 및 심근병증과 같은 잠재적인 심각한 부작용을 모니터링해야 합니다.
AstraZeneca a présenté de nouveaux résultats d'études lors de l'ELCC 2025, renforçant TAGRISSO® (osimertinib) en tant que thérapie de référence pour le cancer du poumon non à petites cellules (NSCLC) avec mutation EGFR. Les principales conclusions incluent :
Le essai de phase III LAURA a montré une tendance à l'amélioration de la survie globale avec TAGRISSO par rapport au placebo dans un contexte de stade III non résécable (58,8 vs 54,1 mois). Le essai de phase II SAVANNAH a démontré un taux de réponse de 56 % en combinant TAGRISSO avec savolitinib chez des patients présentant des niveaux élevés de MET après progression de la maladie. L'essai ORCHARD a montré des résultats prometteurs en combinant TAGRISSO avec datopotamab deruxtecan-dlnk, atteignant jusqu'à 43 % de taux de réponse.
L'analyse de l'essai FLAURA2 a révélé une survie sans progression de plus de deux ans en combinant TAGRISSO avec une chimiothérapie. Les profils de sécurité dans tous les essais étaient cohérents avec les données établies, bien qu'une surveillance soit nécessaire pour d'éventuels effets secondaires graves, notamment des maladies pulmonaires interstitielles, un allongement de l'intervalle QT et une cardiomyopathie.
AstraZeneca hat auf dem ELCC 2025 neue Studienergebnisse präsentiert, die TAGRISSO® (Osimertinib) als Ecktherapie für EGFR-mutiertes nicht-kleinzelliges Lungenkarzinom (NSCLC) stärken. Zu den wichtigsten Ergebnissen gehören:
Die LAURA Phase-III-Studie zeigte einen Trend zu einer verbesserten Gesamtüberlebenszeit mit TAGRISSO im Vergleich zu Placebo im unresezierbaren Stadium III (58,8 vs. 54,1 Monate). Die SAVANNAH Phase-II-Studie demonstrierte eine Ansprechrate von 56%, als TAGRISSO mit Savolitinib bei Patienten mit hohen MET-Werten nach Krankheitsprogression kombiniert wurde. Die ORCHARD-Studie zeigte vielversprechende Ergebnisse bei der Kombination von TAGRISSO mit Datopotamab Deruxtecan-dlnk und erreichte eine Ansprechrate von bis zu 43%.
Die Analyse der FLAURA2-Studie ergab eine progressionsfreie Überlebenszeit von über zwei Jahren bei der Kombination von TAGRISSO mit Chemotherapie. Die Sicherheitsprofile in allen Studien waren konsistent mit den etablierten Daten, jedoch ist eine Überwachung möglicher schwerwiegender Nebenwirkungen erforderlich, einschließlich interstitieller Lungenerkrankung, QT-Intervall-Verlängerung und Kardiomyopathie.
- Improved overall survival trend in LAURA trial (58.8 vs 54.1 months)
- High response rate (56%) in SAVANNAH trial for MET-positive patients
- Strong efficacy in ORCHARD trial with up to 43% response rate
- Extended progression-free survival beyond 2 years in FLAURA2 trial
- Multiple regulatory approvals secured globally
- Significant side effects including potential fatal interstitial lung disease (4% occurrence)
- High rate of Grade 3 or higher adverse events (57%) in SAVANNAH trial
- Treatment discontinuation rates due to adverse events across trials
- Cardiomyopathy risk with 3.8% occurrence rate, including fatal cases
Insights
AstraZeneca's TAGRISSO continues to demonstrate strong clinical evidence across the spectrum of EGFR-mutated NSCLC treatment paradigms. The LAURA trial update shows a 58.8-month median OS with TAGRISSO versus 54.1 months for placebo (HR=0.67) in the unresectable Stage III setting, despite high crossover rates, reinforcing its post-chemoradiotherapy efficacy.
The SAVANNAH data reveals targeted MET inhibition strategy with TAGRISSO-savolitinib combination yielding a 56% response rate and 7.4-month PFS in patients with high MET expression after TAGRISSO progression. This represents a significant advance for the ~34% of patients who develop this specific resistance mechanism.
For broader resistance patterns, the ORCHARD trial demonstrates TAGRISSO plus datopotamab deruxtecan-dlnk achieving 36-43% response rates with promising 11.7-month median PFS at the 6mg/kg dose level. This ADC combination could potentially address multiple resistance mechanisms without requiring biomarker testing.
The FLAURA2 analysis confirms that first-line TAGRISSO plus chemotherapy maintains 2+ year PFS regardless of maintenance duration, with manageable toxicity profiles. These findings collectively establish TAGRISSO as the cornerstone therapy for EGFR-mutated NSCLC across treatment settings, with strategic combinations addressing progression patterns.
These multiple positive trial results significantly strengthen AstraZeneca's market position in the $5+ billion EGFR inhibitor space. The LAURA trial's continued survival trend provides critical differentiation in earlier-stage disease where competition remains , creating a potential monopoly in the unresectable Stage III setting following regulatory approvals.
The combination strategies address the critical challenge of acquired resistance - TAGRISSO's primary commercial vulnerability. The SAVANNAH data provides a precision medicine approach for MET-driven resistance, while the ORCHARD results offer a broader solution through ADC technology. Both represent substantial commercial opportunities that could extend TAGRISSO's clinical utility and revenue lifecycle by becoming standard post-progression therapies.
The FLAURA2 maintenance analysis helps optimize the duration of combination therapy, addressing both efficacy and toxicity concerns while maintaining the survival benefits that drove approval. This will likely improve real-world adoption rates of the combination approach.
Strategically, these developments position AstraZeneca to dominate the entire EGFR treatment continuum: first-line, first-line intensification, adjuvant, maintenance, and now multiple post-progression settings. This comprehensive clinical program creates substantial barriers to competitor entry while maximizing the value extraction from a single molecule through multiple indications and combination approaches.
In LAURA Phase III trial, TAGRISSO continues to demonstrate improved overall survival trend in unresectable, Stage III setting
SAVANNAH and ORCHARD Phase II trials show the addition of savolitinib or datopotamab deruxtecan-dlnk to TAGRISSO upon disease progression demonstrates strong clinical activity
- LAURA Phase III trial of TAGRISSO in unresectable, Stage III EGFRm NSCLC after chemoradiotherapy (CRT) (LBA4).
- SAVANNAH Phase II trial of TAGRISSO plus savolitinib in advanced EGFRm NSCLC with high levels of MET overexpression and/or amplification following disease progression on 1st-line TAGRISSO (#2O).
- ORCHARD Phase II platform trial of TAGRISSO plus datopotamab deruxtecan-dlnk in advanced EGFRm NSCLC following disease progression on 1st-line TAGRISSO (#1O).
- FLAURA2 Phase III trial of TAGRISSO plus chemotherapy as 1st-line treatment for advanced EGFRm NSCLC (#53P).
Myung-Ju Ahn, MD, PhD, Professor of Hemato-Oncology at the Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine,
Susan Galbraith, Executive Vice President, Oncology Hematology R&D, AstraZeneca, said: “Having now treated more than one million patients around the world, TAGRISSO has repeatedly transformed expectations for patients with EGFR-mutated lung cancer by not only extending survival but also showing it is possible to maintain quality of life during cancer treatment. The breadth of data at ELCC reinforce TAGRISSO as the backbone therapy for patients with this disease and show that adding savolitinib or datopotamab deruxtecan-dlnk at the time of disease progression can help prolong patients’ responses to treatment.”
Professor Virginia Harrison, EGFR Positive
TAGRISSO continued to demonstrate encouraging overall survival (OS) trend in unresectable, Stage III setting in LAURA trial
Updated results from the LAURA Phase III trial showed an improved trend towards OS benefit with TAGRISSO compared to placebo in patients with unresectable, Stage III EGFRm NSCLC (hazard ratio [HR] 0.67;
TAGRISSO previously demonstrated a statistically significant and highly clinically meaningful improvement in progression-free survival (PFS). These results were published in The New England Journal of Medicine and formed the basis for regulatory approvals around the world including in the US, EU and
Safety results and discontinuation rates due to adverse events (AEs) were as expected and no new safety concerns were identified.
TAGRISSO plus savolitinib showed durable response rates in lung cancer patients with high levels of MET overexpression and/or amplification whose disease progressed on 1st-line TAGRISSO in SAVANNAH trial
Results from the SAVANNAH Phase II trial showed TAGRISSO plus savolitinib (300 mg twice-daily [BID]) demonstrated a clinically meaningful and durable objective response rate (ORR) in patients with EGFRm NSCLC with high levels of MET overexpression and/or amplification whose disease progressed on treatment with 1st-line TAGRISSO. Among patients screened for enrollment in SAVANNAH, an estimated
TAGRISSO plus savolitinib demonstrated a confirmed ORR of
Safety results and discontinuation rates due to AEs were consistent with the established profiles of each medicine and no new safety concerns were reported. In all patients treated with TAGRISSO plus savolitinib (300 mg BID), Grade 3 or higher AEs occurred in
Savolitinib is an oral, potent and highly selective MET tyrosine kinase inhibitor (TKI) being jointly developed and commercialized by AstraZeneca and HUTCHMED. In 2023, TAGRISSO plus savolitinib received Fast Track designation from the Food and Drug Administration (FDA) in this setting.
TAGRISSO plus datopotamab deruxtecan-dlnk showed encouraging response rates in patients whose disease progressed on 1st-line TAGRISSO in ORCHARD trial
First results from the TAGRISSO plus datopotamab deruxtecan-dlnk module of the ORCHARD Phase II platform trial showed the combination demonstrated promising efficacy and manageable safety in patients with advanced EGFRm NSCLC whose disease progressed on treatment with TAGRISSO.
The module enrolled an all-comer population of patients with EGFRm NSCLC and evaluated two doses of datopotamab deruxtecan-dlnk (4 or 6 mg/kg) which, in combination with TAGRISSO, showed similar ORRs of
The safety profile of TAGRISSO plus datopotamab deruxtecan-dlnk was consistent with the known safety profiles of each medicine and no new safety concerns were identified at either dose level. Grade 3 or higher treatment-related AEs occurred in
Datopotamab deruxtecan-dlnk is a specifically engineered TROP2-directed antibody drug conjugate (ADC) discovered by Daiichi Sankyo and being jointly developed and commercialized by AstraZeneca and Daiichi Sankyo. The Companies are evaluating datopotamab deruxtecan-dlnk alone and with TAGRISSO as treatment for patients with advanced or metastatic EGFRm NSCLC in the TROPION-Lung14 and TROPION-Lung15 Phase III trials.
New results for TAGRISSO plus chemotherapy in the 1st-line setting reinforce strong PFS benefit in FLAURA2 Phase III trial
An exploratory post-hoc analysis of the FLAURA2 Phase III trial assessed PFS by length of exposure to pemetrexed maintenance treatment in patients with locally advanced (Stage IIIB-IIIC) or metastatic (Stage IV) EGFRm NSCLC. Patients were treated with TAGRISSO with the addition of chemotherapy (pemetrexed plus cisplatin) followed by maintenance treatment with TAGRISSO and chemotherapy (pemetrexed) or TAGRISSO alone. Results showed an mPFS of more than two years regardless of length of pemetrexed maintenance exposure, with a trend associating longer PFS with longer pemetrexed treatment.
The safety profile of TAGRISSO plus chemotherapy was consistent with the established profiles of the individual medicines. Grade 3 or higher chemotherapy-related AEs were reported in
TAGRISSO plus chemotherapy previously demonstrated a statistically significant and clinically meaningful improvement in PFS. These results were published in The New England Journal of Medicine and formed the basis for regulatory approvals around the world including in the US, EU,
IMPORTANT SAFETY INFORMATION
- There are no contraindications for TAGRISSO
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TAGRISSO can cause severe and fatal interstitial lung disease (ILD)/pneumonitis. ILD/pneumonitis occurred in
4% of the 1813 patients treated with TAGRISSO monotherapy who had not received recent definitive chemoradiation therapy;0.4% of cases were fatal
ILD/Pneumonitis with TAGRISSO in combination with Pemetrexed and Platinum-based Chemotherapy:
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In the FLAURA2 study, ILD/pneumonitis occurred in
3.3% of the 276 patients who received TAGRISSO in combination with pemetrexed and platinum-based chemotherapy;0.4% of cases were fatal
ILD/Pneumonitis Following Definitive Platinum-based Chemoradiation Therapy (CRT):
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In the LAURA study, following definitive platinum-based CRT, ILD/pneumonitis including radiation pneumonitis, occurred in 80 of the 143 patients (
56% ) who received TAGRISSO monotherapy and 28 of the 73 patients (38% ) who received placebo. There was one fatal case (0.7% ),3.5% Grade 3,34% Grade 2, and18% Grade 1 adverse reactions of ILD/pneumonitis in TAGRISSO-treated patients. For TAGRISSO-treated patients, ILD/pneumonitis led to permanent discontinuation of TAGRISSO in7% of patients and dosage interruptions of TAGRISSO in35% of patients. Among the 46 patients who were rechallenged with TAGRISSO,11% had recurrence of ILD/pneumonitis. In the 80 TAGRISSO-treated patients, ILD/pneumonitis resolved in40% , resolved with sequelae in1.3% , were resolving in16% , did not resolve in41% , and resulted in death in1.3%
For patients receiving TAGRISSO who have not received recent definitive platinum-based CRT, withhold TAGRISSO and promptly investigate for ILD in patients who present with worsening of respiratory symptoms which may be indicative of ILD (e.g., dyspnea, cough, and fever). Permanently discontinue TAGRISSO if ILD/pneumonitis is confirmed. For patients who have received recent definitive platinum-based CRT with Grade 1 ILD/pneumonitis, continue TAGRISSO or interrupt and restart, as appropriate. Permanently discontinue TAGRISSO in patients diagnosed with Grade ≥2 ILD/pneumonitis
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TAGRISSO can cause heart rate-corrected QT (QTc) interval prolongation. Of the 1813 TAGRISSO monotherapy-treated patients in clinical trials,
1.1% were found to have a QTc >500 msec, and4.3% of patients had an increase from baseline QTc >60 msec. Of the 276 patients treated with TAGRISSO in combination with pemetrexed and platinum-based chemotherapy in the FLAURA2 study,1.8% were found to have a QTc >500 msec, and10.5% of patients had an increase from baseline QTc >60 msec. No QTc-related arrhythmias were reported. Clinical trials of TAGRISSO did not enroll patients with baseline QTc of >470 msec. Conduct periodic monitoring with ECGs and electrolytes in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Permanently discontinue TAGRISSO in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia
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TAGRISSO can cause cardiomyopathy, including cardiac failure, chronic cardiac failure, congestive heart failure, pulmonary edema or decreased ejection fraction. Cardiomyopathy occurred in
3.8% of the 1813 TAGRISSO-treated patients;0.1% of cardiomyopathy cases were fatal. In the FLAURA2 study, cardiomyopathy occurred in9% of the 276 patients who received TAGRISSO in combination with pemetrexed and platinum-based chemotherapy;1.1% of cardiomyopathy cases were fatal. A decline in left ventricular ejection fraction (LVEF) ≥10% from baseline and to <50% LVEF occurred in4.2% of 1557 patients who had baseline and at least one follow-up LVEF assessment. In the ADAURA study,1.5% (5/325) of TAGRISSO-treated patients experienced LVEF decreases ≥10% from baseline and a drop to <50% . In the LAURA study, following platinum-based CRT,3% (4/135) of TAGRISSO-treated patients and no placebo-treated patients experienced LVEF decreases ≥10% and a drop to <50% . In the FLAURA2 study,8% (21/262) of patients treated with TAGRISSO in combination with pemetrexed and platinum-based chemotherapy, who had baseline and at least one follow-up LVEF assessment, experienced LVEF decreases ≥10% and a drop to <50% . For patients receiving TAGRISSO monotherapy, conduct cardiac monitoring in patients with cardiac risk factors, including assessment of LVEF at baseline and during treatment. For patients receiving TAGRISSO in combination with pemetrexed and platinum-based chemotherapy, conduct cardiac monitoring in all patients, including assessment of LVEF at baseline and during treatment. Assess LVEF in patients who develop relevant cardiac signs or symptoms during treatment. For symptomatic congestive heart failure, permanently discontinue TAGRISSO
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Keratitis was reported in
0.6% of 1813 patients treated with TAGRISSO monotherapy in clinical trials. Promptly refer patients with signs and symptoms suggestive of keratitis (such as eye inflammation, lacrimation, light sensitivity, blurred vision, eye pain and/or red eye) to an ophthalmologist
- Postmarketing cases consistent with erythema multiforme major (EMM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported in patients receiving TAGRISSO. Withhold TAGRISSO if EMM, SJS, or TEN is suspected and permanently discontinue if confirmed
- Postmarketing cases of cutaneous vasculitis including leukocytoclastic vasculitis, urticarial vasculitis, and IgA vasculitis have been reported in patients receiving TAGRISSO. Withhold TAGRISSO if cutaneous vasculitis is suspected, evaluate for systemic involvement, and consider dermatology consultation. If no other etiology can be identified, consider permanent discontinuation of TAGRISSO based on severity
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Aplastic anemia has been reported in TAGRISSO-treated patients in clinical trials (
0.06% of 1813) and postmarketing. Some cases had a fatal outcome. Inform patients of the signs and symptoms of aplastic anemia including but not limited to, new or persistent fevers, bruising, bleeding, and pallor. If aplastic anemia is suspected, withhold TAGRISSO and obtain a hematology consultation. If aplastic anemia is confirmed, permanently discontinue TAGRISSO. Perform complete blood count with differential before starting TAGRISSO, periodically throughout treatment, and more frequently if indicated
- Verify pregnancy status of females of reproductive potential prior to initiating TAGRISSO. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with TAGRISSO and for 6 weeks after the last dose. Advise males with female partners of reproductive potential to use effective contraception for 4 months after the last dose
- Because of the potential for serious adverse reactions in breastfed infants from TAGRISSO, women should not breastfeed during treatment with TAGRISSO and for 2 weeks after the last dose
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Most common (≥
20% ) adverse reactions, including laboratory abnormalities, were:- TAGRISSO monotherapy: leukopenia, lymphopenia, thrombocytopenia, anemia, diarrhea, rash, musculoskeletal pain, neutropenia, nail toxicity, dry skin, stomatitis, and fatigue
- TAGRISSO monotherapy following platinum-based chemoradiation therapy: lymphopenia, leukopenia, ILD/pneumonitis, thrombocytopenia, neutropenia, rash, diarrhea, nail toxicity, musculoskeletal pain, cough and COVID-19
- TAGRISSO in combination with pemetrexed and platinum-based chemotherapy: leukopenia, thrombocytopenia, neutropenia, lymphopenia, rash, diarrhea, stomatitis, nail toxicity, dry skin, and increased blood creatinine
INDICATIONS
- TAGRISSO is indicated as adjuvant therapy after tumor resection in adult patients with non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test
- TAGRISSO is indicated for the treatment of adult patients with locally advanced, unresectable (stage III) NSCLC whose disease has not progressed during or following concurrent or sequential platinum-based chemoradiation therapy and whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test
- TAGRISSO is indicated for the first-line treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test
- TAGRISSO is indicated in combination with pemetrexed and platinum-based chemotherapy, for the first-line treatment of adult patients with locally advanced or metastatic NSCLC whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test
- TAGRISSO is indicated for the treatment of adult patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation-positive NSCLC, as detected by an FDA-approved test, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy
Notes
NSCLC
Lung cancer is the leading cause of cancer death among men and women, accounting for about one-fifth of all cancer deaths.1 Lung cancer is broadly split into small cell lung cancer or NSCLC, the latter accounting for about
While EGFR-TKIs have significantly improved outcomes in the 1st-line setting, mechanisms of resistance and disease progression are extremely common, and a significant unmet need exists in later-line settings for effective and well-tolerated treatment options.6-9
LAURA
LAURA is a randomized, double-blind, placebo-controlled, multi-center, global Phase III trial in patients with unresectable, Stage III EGFRm NSCLC whose disease has not progressed following definitive platinum-based CRT. Patients were treated with TAGRISSO 80 mg once-daily (QD) oral tablets until disease progression, unacceptable toxicity or other discontinuation criteria were met. Upon progression, patients in the placebo arm were offered treatment with TAGRISSO.
The trial enrolled 216 patients in more than 145 centers across more than 15 countries, including in the US,
SAVANNAH
SAVANNAH is an ongoing randomized, global Phase II trial studying the efficacy of savolitinib added to TAGRISSO in patients with EGFRm, locally advanced or metastatic NSCLC with MET overexpression and/or amplification whose disease progressed following treatment with TAGRISSO. Based on the original single-arm trial design, patients were treated with savolitinib 300 or 600 mg QD or 300 mg BID, in combination with oral TAGRISSO 80 mg QD. In 2022, a comparison of savolitinib 300 mg BID and TAGRISSO 80 mg QD to savolitinib 300 mg BID and placebo was added to the trial to evaluate contribution of components.
The trial has enrolled 369 patients to date in more than 80 centers globally, including in the US,
In August 2022, positive interim ORR results from the SAVANNAH trial were presented at the International Association for the Study of Lung Cancer 2022 World Conference on Lung Cancer (WCLC).
The global SAFFRON Phase III trial will further assess the TAGRISSO plus savolitinib combination versus platinum-based doublet chemotherapy in patients with EGFRm, MET-overexpressed and/or amplified, locally advanced or metastatic NSCLC following treatment with TAGRISSO. Patients are being prospectively selected using the high MET level cut-off identified in SAVANNAH.
ORCHARD
ORCHARD (Osimertinib Resistance CoHorts, Addressing 1L Relapse Drivers) is an open-label, multi-center Phase II platform trial evaluating numerous TAGRISSO-based combinations as a treatment for patients with advanced EGFRm NSCLC whose disease has progressed on 1st-line TAGRISSO. The trial has 10 modules examining the efficacy, safety and tolerability of these targeted and non-targeted combination options, including TAGRISSO 80 mg QD plus datopotamab deruxtecan-dlnk given intravenously at 4 or 6 mg/kg on day one of every three-week cycle.
The trial has enrolled 247 patients to date in more than 40 centers globally, including in the US,
FLAURA2
FLAURA2 is a randomized, open-label, multi-center, global Phase III trial in the 1st-line treatment of patients with locally advanced (Stage IIIB-IIIC) or metastatic (Stage IV) EGFRm NSCLC. Patients were treated with TAGRISSO 80 mg QD oral tablets with the addition of chemotherapy (pemetrexed (500 mg/m2) plus cisplatin (75 mg/m2) or carboplatin (AUC5) every three weeks for four cycles, followed by TAGRISSO with pemetrexed maintenance every three weeks.
The trial enrolled 557 patients in more than 150 centers across more than 20 countries, including in the US,
TAGRISSO
TAGRISSO® (osimertinib) is a third-generation, irreversible EGFR-TKI with proven clinical activity in NSCLC, including against central nervous system metastases. TAGRISSO (40 mg and 80 mg QD oral tablets) has been used to treat patients across its indications worldwide and AstraZeneca continues to explore TAGRISSO as a treatment for patients across multiple stages of EGFRm NSCLC.
There is an extensive body of evidence supporting the use of TAGRISSO in EGFRm NSCLC. TAGRISSO is the only targeted therapy to improve patient outcomes in early-stage disease in the NeoADAURA and ADAURA Phase III trials, locally advanced stages in the LAURA Phase III trial and late-stage disease in the FLAURA and FLAURA2 Phase III trials.
As part of AstraZeneca’s ongoing commitment to treating patients as early as possible in lung cancer, TAGRISSO is also being investigated in the early-stage adjuvant resectable setting in the ADAURA2 Phase III trial.
Savolitinib
Savolitinib is an oral, potent, and highly selective MET TKI that has demonstrated clinical activity in advanced solid tumors. MET is a tyrosine kinase receptor that has an essential role in normal cell development. Savolitinib blocks atypical activation of the MET receptor tyrosine kinase pathway that occurs because of mutations (such as exon 14 skipping alterations or other point mutations), gene amplification or protein overexpression. MET overexpression and/or amplification can lead to tumor growth and the metastatic progression of cancer cells, and is a known mechanism of acquired resistance to EGFR TKIs. The prevalence of MET depends on the sample type, detection method and assay cut-off used.
Savolitinib is approved in
It is currently under clinical development for multiple tumor types, including lung, kidney and gastric cancers as a single treatment and in combination with other medicines.
Datopotamab deruxtecan-dlnk
Datopotamab deruxtecan-dlnk (datopotamab deruxtecan in rest of world) is a TROP2-directed ADC. Designed using Daiichi Sankyo’s proprietary DXd ADC Technology, datopotamab deruxtecan-dlnk is one of six DXd ADCs in the oncology pipeline of Daiichi Sankyo, and one of the most advanced programs in AstraZeneca’s ADC scientific platform. Datopotamab deruxtecan-dlnk is comprised of a humanized anti-TROP2 IgG1 monoclonal antibody, developed in collaboration with Sapporo Medical University, attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers.
Datopotamab deruxtecan-dlnk (6 mg/kg) is approved in the US,
In the US, a Biologics License Application for datopotamab deruxtecan-dlnk is under Priority Review for the treatment of adult patients with locally advanced or metastatic EGFRm NSCLC who have received prior systemic therapies, including an EGFR-directed therapy. Datopotamab deruxtecan-dlnk was also granted Breakthrough Therapy Designation by the FDA for this patient population.
AstraZeneca in lung cancer
AstraZeneca is working to bring patients with lung cancer closer to cure through the detection and treatment of early-stage disease, while also pushing the boundaries of science to improve outcomes in the resistant and advanced settings. By defining new therapeutic targets and investigating innovative approaches, the Company aims to match medicines to the patients who can benefit most.
The Company’s comprehensive portfolio includes leading lung cancer medicines and the next wave of innovations, including TAGRISSO and gefitinib; durvalumab and tremelimumab-actl; fam-trastuzumab deruxtecan-nxki and datopotamab deruxtecan-dlnk in collaboration with Daiichi Sankyo; savolitinib in collaboration with HUTCHMED; as well as a pipeline of potential new medicines and combinations across diverse mechanisms of action.
AstraZeneca is a founding member of the Lung Ambition Alliance, a global coalition working to accelerate innovation and deliver meaningful improvements for people with lung cancer, including and beyond treatment.
AstraZeneca in oncology
AstraZeneca is leading a revolution in oncology with the ambition to provide cures for cancer in every form, following the science to understand cancer and all its complexities to discover, develop and deliver life-changing medicines to patients.
The Company’s focus is on some of the most challenging cancers. It is through persistent innovation that AstraZeneca has built one of the most diverse portfolios and pipelines in the industry, with the potential to catalyze changes in the practice of medicine and transform the patient experience.
AstraZeneca has the vision to redefine cancer care and, one day, eliminate cancer as a cause of death.
AstraZeneca
AstraZeneca is a global, science-led biopharmaceutical company that focuses on the discovery, development and commercialization of prescription medicines in Oncology, Rare Diseases and BioPharmaceuticals, including Cardiovascular, Renal & Metabolism, and Respiratory & Immunology. Based in
References
- World Health Organization. International agency for research on cancer: lung cancer fact sheet. Available at: https://gco.iarc.who.int/media/globocan/factsheets/cancers/15-trachea-bronchus-and-lung-fact-sheet.pdf. Accessed March 2025.
- American Cancer Society. What is lung cancer? Available at: https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html. Accessed March 2025.
- Keedy VL, et al. American Society of Clinical Oncology Provisional Clinical Opinion: epidermal growth factor receptor (EGFR) mutation testing for patients with advanced non-small-cell lung cancer considering first-line EGFR tyrosine kinase inhibitor therapy. J Clin Oncol. 2011;29:2121-2127.
- Szumera-Ciećkiewicz A, et al. EGFR mutation testing on cytological and histological samples in non-small cell lung cancer: a polish, single institution study and systematic review of european incidence. Int J Clin Exp Pathol. 2013;6:2800-2812.
- Ellison G, et al. EGFR mutation testing in lung cancer: a review of available methods and their use for analysis of tumour tissue and cytology samples. J Clin Pathol. 2013;66:79-89.
- Chen R, et al. Emerging therapeutic agents for advanced non-small cell lung cancer. J Hematol Oncol. 2020;13(1):58.
- Majeed U, et al. Targeted therapy in advanced non-small cell lung cancer: current advances and future trends. J Hematol Oncol. 2021;14(1):108.
- Morgillo F, et al. Mechanisms of resistance to EGFR-targeted drugs: lung cancer. ESMO Open. 2016;1(3):e000060.
- Han B, et al. Efficacy of pemetrexed-based regimens in advanced non-small cell lung cancer patients with activating epidermal growth factor receptor mutations after tyrosine kinase inhibitor failure: a systematic review. Onco Targets Ther. 2018;11:2121-2129.
US-99612 Last Updated 3/25
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Source: AstraZeneca