Roy S. Herbst, MD, PhD, Discusses ADAURA Trial and Future of Lung Cancer Treatment

Roy S. Herbst, MD, PhD, of the Yale Cancer Center discussed the future of lung cancer treatment to follow the phase 3 ADAURA trial regarding osimertinib as adjuvant therapy to treat NSCLC presented at the 2020 ASCO Virtual Scientific Program.

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There is a trial called neo ADAURA which is being looked at. Certainly, if you can use this in adjuvant therapy the next step would be can you move it even earlier to neo-adjuvant meaning before surgery, or even in patients who don’t even have cancer yet, maybe as a chemo prevention. That’s a bit a way away, but neo-adjuvant therapy is very nice because you give the drug, you can actually watch the tumor shrink before you operate perhaps doing a smaller surgery. You have a full pathology available at surgery, so you know if you have sensitive or resistant cells. Presumably they mostly sensitive if the tumors shrinking, but that could be an even more potent way of using these drugs and it’s the next step. We started in the most advanced setting, AURA first, second-line advanced disease, then FLORA, then metastatic front-line setting, now moving it to the adjuvant setting. really when you get patients with less disease, less tumor heterogeneity, fewer cells, hopefully a chance for a cure here, and that’s the goal. Then, move it even earlier before you even do surgery, to have even greater effect. All of this is very exciting, and I would say it’s not going to be just with osimertinib. I predict we’ll see this with other targets in lung cancer. This is a new paradigm for the treatment of lung cancer and preventing metastatic disease.