Luo Faustine X, Arter Zhaohui, Ou Sai-Hong Ignatius, Nagasaka Misako
Chao Family Comprehensive Cancer Center, Orange, CA, 92868, USA.
University of California Irvine School of Medicine, Orange, CA, 92868, USA.
Lung Cancer (Auckl). 2025 Apr 25;16:51-55. doi: 10.2147/LCTT.S520833. eCollection 2025.
The current standard of care for unresectable stage III non-small cell lung cancer (NSCLC) involves a concurrent platinum-based doublet chemotherapy and chest radiotherapy, followed by consolidative therapy with durvalumab, an anti-programmed death ligand 1 (PD-L1) antibody, based on the PACIFIC trial (NCT02125461). However, the utility of durvalumab in -mutated lung cancer patients is questionable based on post-hoc analysis and multi-institutional retrospective analysis. Osimertinib is a third-generation -tyrosine kinase inhibitor (TKI) with proven clinical efficacy in NSCLC. Given that durvalumab showed no benefit in unresectable Stage III -mutated NSCLC, it is exciting that most recently, the LAURA trial has demonstrated promising outcomes with adjuvant osimertinib in unresectable, stage III -mutated NSCLC after definitive chemoradiotherapy with significant improvement in PFS compared to placebo. Furthermore, the LAURA trial demonstrates that osimertinib has a protective effect against distant metastases and CNS progression in this patient population. Here, we explore the results of the LAURA trial and how it transforms the standard-of-care treatment for patients with unresectable, stage III -mutated NSCLC moving forward.
目前,不可切除的III期非小细胞肺癌(NSCLC)的标准治疗方案包括同步铂类双药化疗和胸部放疗,随后根据PACIFIC试验(NCT02125461)采用抗程序性死亡配体1(PD-L1)抗体度伐利尤单抗进行巩固治疗。然而,根据事后分析和多机构回顾性分析,度伐利尤单抗在EGFR突变肺癌患者中的效用存在疑问。奥希替尼是一种第三代EGFR酪氨酸激酶抑制剂(TKI),在NSCLC中具有已证实的临床疗效。鉴于度伐利尤单抗在不可切除的III期EGFR突变NSCLC中未显示出益处,最近LAURA试验在不可切除的III期EGFR突变NSCLC患者接受根治性放化疗后使用辅助奥希替尼取得了有前景的结果,与安慰剂相比无进展生存期(PFS)有显著改善,这令人兴奋。此外,LAURA试验表明奥希替尼对该患者群体的远处转移和中枢神经系统进展具有保护作用。在此,我们探讨LAURA试验的结果以及它如何改变不可切除的III期EGFR突变NSCLC患者未来的标准治疗。