For patients with metastatic EGFR T790M mutation-positive NSCLC, as detected by an FDA-approved test, at progression on or after TKI therapy
*As determined by investigator assessment (IA).
Reduction in relative risk of progression (HR <0.50) was seen across subgroups: brain metastases, mutation status, ethnicity, gender, age, or smoking status.
Primary endpoint: progression-free survival (PFS)
Secondary endpoints: overall response rate (ORR), duration of response (DOR), and overall survival (OS)
‡Pemetrexed 500 mg/m2 with carboplatin (AUC5) or pemetrexed 500 mg/m2 with cisplatin 75 mg/m2 for up to 6 cycles.View full AURA3 study design on ClinicalTrials.gov
In patients treated with TAGRISSO once daily in AURA3, 2.9% had a dose reduction.
§NCI CTCAE v4.0.
||No Grade 4 events were reported.
¶Includes rash, rash generalized, rash erythematous, rash macular, rash maculopapular, rash papular, rash pustular, erythema, folliculitis, acne, dermatitis, and acneiform dermatitis.
#Includes dry skin, eczema, skin fissures, xerosis.
**Includes nail disorders, nail bed disorders, nail bed inflammation, nail bed tenderness, nail discoloration, nail dystrophy, nail infection, nail ridging, nail toxicity, onychoclasis, onycholysis, onychomadesis, paronychia.
††Includes pruritus, pruritus generalized, eyelid pruritus.
‡‡Includes fatigue, asthenia.
§§NCI CTCAE v4.0.
IIIIEach test incidence, except for hyperglycemia, is based on the number of patients who had both baseline and at least one on-study laboratory measurement available (TAGRISSO 279, EGFR TKI comparator 131).
¶¶Hyperglycemia is based on the number of patients who had both baseline and at least one on-study laboratory measurement available (TAGRISSO 270, Chemotherapy 5: fasting glucose was not a protocol requirement for patients in the chemotherapy arm).
TAGRISSO has the only FDA-approved, clinically validated companion diagnostic test for the EGFR T790M mutation that uses either tissue or plasma.1
The cobas® EGFR Mutation Test v2 is an FDA-approved companion diagnostic## to test for the EGFR T790M mutation from FFPE tumor tissue or circulating tumor DNA (ctDNA) from plasma derived from peripheral whole blood.3
The cobas® EGFR Mutation Test v2 has been validated against next-generation sequencing (NGS), with FFPE tissue samples and plasma-based ctDNA samples, and has been shown to be both sensitive to and specific for the detection of EGFR T790M mutations.3
##Companion diagnostics are in vitro diagnostic devices or imaging tools that identify patients who are most likely to benefit from a specific therapeutic agent and provide information essential for the safe and effective use of a corresponding therapeutic product.
References: 1. TAGRISSO [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2018. 2. Mok TS, Wu YL, Ahn MJ, et al. Osimertinib or platinum-pemetrexed in EGFR T790M-positive lung cancer. N Engl J Med. 2017;376:629-640. 3. cobas® EGFR Mutation Test v2 [package insert]. Indianapolis, IN: Roche Molecular Systems, Inc.; 2016.
There are no contraindications for TAGRISSO
Interstitial lung disease (ILD)/pneumonitis occurred in 3.9% of the 1142 TAGRISSO-treated patients; 0.4% of cases were fatal. Withhold TAGRISSO and promptly investigate for ILD in patients who present with worsening of respiratory symptoms which may be indicative of ILD (eg, dyspnea, cough and fever). Permanently discontinue TAGRISSO if ILD is confirmed
Heart rate-corrected QT (QTc) interval prolongation occurred in TAGRISSO-treated patients. Of the 1142 TAGRISSO-treated patients in clinical trials, 0.9% were found to have a QTc > 500 msec, and 3.6% of patients had an increase from baseline QTc > 60 msec. No QTc-related arrhythmias were reported. 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
Cardiomyopathy occurred in 2.6% of the 1142 TAGRISSO-treated patients; 0.1% of cardiomyopathy cases were fatal. A decline in left ventricular ejection fraction (LVEF) ≥10% from baseline and to <50% LVEF occurred in 3.9% of 908 patients who had baseline and at least one follow-up LVEF assessment. Conduct cardiac monitoring, including assessment of LVEF at baseline and during treatment, in patients with cardiac risk factors. Assess LVEF in patients who develop relevant cardiac signs or symptoms during treatment. For symptomatic congestive heart failure, permanently discontinue TAGRISSO
Keratitis was reported in 0.7% of 1142 patients treated with TAGRISSO 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
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 final dose. Advise males with female partners of reproductive potential to use effective contraception for 4 months after the final dose
Most common adverse reactions (≥20%) were diarrhea, rash, dry skin, nail toxicity, stomatitis, fatigue and decreased appetite
TAGRISSO is indicated for the first-line treatment of 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 for the treatment of patients with metastatic 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
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