Combination Therapies May Improve Survival in EGFR+ Lung Cancer

Treating patients with combination therapy approaches may improve survival for patients with EGFR-positive lung cancer when compared with monotherapy treamtents, such as giving Tagrisso (osimertinib) alone, Dr. Edgardo Santos said in an interview with CURE.

Santos, medical director of the Broward County Oncology Institute of Hope and Innovation in Florida, discussed recent data from the FLAURA2 and MARIPOSA trials. In FLAURA2, Tagrisso plus chemotherapy outperformed Tagrisso alone, while MARIPOSA showed that Rybrevant (amivantamab) plus Leclaza (lazertinib), a chemotherapy-free option, also provided a survival benefit.

Santos explained that for six years, Tagrisso monotherapy was the standard, but these results now push physicians to evaluate whether patients may benefit more from monotherapy or a combination approach, depending on risk factors.

Transcript

What are the potential benefits of taking Tagrisso alone versus combining it with other therapies?

Tagrisso became the preferred agent in our guidelines back in 2019 based on a clinical trial called FLAURA. As the years have passed, more research has come forward, and today we have two other therapies that use combination approaches.

One of them was presented today at the IASLC 2025 World Conference on Lung Cancer: the FLAURA2 trial. FLAURA2 showed an overall survival benefit. This [study evaluated] the combination of Tagrisso plus chemotherapy versus Tagrisso alone.

The other study, MARIPOSA, also showed a positive overall survival benefit with a chemotherapy-free combination. This involves Leclaza plus Rybrevant, a monoclonal antibody. That combination also showed superiority over Tagrisso alone.

So, today, when a patient comes to the clinic, I always encourage them to talk with their thoracic or medical oncologist about all options. For the past six years, Tagrisso alone was the standard. Now, we as physicians need to discuss whether a patient is a candidate for monotherapy or if combination therapy is more appropriate. Based on risk factors and findings from these two latest studies, MARIPOSA and FLAURA2, we are now able to better identify high-risk features in patients with EGFR mutations.

Transcript has been edited for clarity and conciseness.

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