A phase II, multicenter study of lazertinib as consolidation therapy in patients with locally advanced, unresectable, EGFR mutation-positive non-small cell lung cancer (stage III) who have not progressed following definitive, platinum-based, chemoradiation therapy (PLATINUM trial)

Juwhan Choi, Jeong Eun Lee, Chang-Min Choi, In-Jae Oh, Kye Young Lee, Tae Won Jang, Seung Hyeun Lee, Eun Young Kim, Dong Won Park, Sun Hyo Park, Sung Yong Lee, Juwhan Choi, Jeong Eun Lee, Chang-Min Choi, In-Jae Oh, Kye Young Lee, Tae Won Jang, Seung Hyeun Lee, Eun Young Kim, Dong Won Park, Sun Hyo Park, Sung Yong Lee

Abstract

Introduction: The PACIFIC study demonstrated that durvalumab consolidation therapy significantly improved progression-free survival (PFS) and overall survival (OS) in patients with unresectable stage III non-small cell lung cancer (NSCLC) after concurrent chemoradiotherapy (CCRT). However, there was no clinical benefit in both PFS and OS in epidermal growth factor receptor (EGFR) mutation-positive patient groups in a post hoc exploratory analysis. Moreover, the clinical effects of immune checkpoint inhibitors (ICIs) in EGFR mutation-positive stage IV NSCLC were demonstrated to be poor. Personalized treatment according to the mutation status is also required in stage III NSCLC. Lazertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), is newly developed and approved for use in Korea.

Methods: This prospective, open, single-arm, multicenter, phase II clinical trial aims to evaluate the efficacy and safety of lazertinib as a consolidative therapy after CCRT treatment in unresectable, EGFR mutation-positive NSCLC stage III patients. The primary endpoint of this study is PFS, and the secondary endpoints are OS, objective response rate (ORR), duration of response (DoR), time to death or distant metastasis (TTDM), and safety profiles.

Discussion: Our study may extend the indications for third-generation EGFR-TKIs to treat patients with stage III NSCLC. Moreover, using this drug to treat stage III NSCLC would emphasize the value of mutation analysis and personalized medicine.

Trial registration: ClinicalTrials.gov NCT05338619.

Keywords: EGFR; chemoradiotherapy; consolidation therapy; lazertinib.

Conflict of interest statement

The authors have no conflicts of interest to declare.

© 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Figures

FIGURE 1
FIGURE 1
Study flowchart. PD, progressive disease; PFS, progression‐free survival; OS, overall survival; ORR, objective response rate; DoR, duration of response; TTDM, time to death or distant metastasis

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