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Study Design
OS Data
OS Subgroup Data
Other key data:1)Time to Symptomatic Progression (TTSP): The combination group and the osimertinib group were respectively:43.6 months vs 29.3 months (HR=0.69; P<0.001).2)Intracranial Progression-Free Survival (icPFS): Median icPFS: Combination group and Osimertinib group, respectively25.4 months vs 22.2 months (HR=0.79; P=0.07); 3-year icPFS rate: Combination group and Osimertinib group, respectively36% vs 18% (Significant Difference).3)Treatment Crossover and Subsequent Therapy: The trial did not allow crossover from the osimertinib group to the combination group, but the proportion of patients receiving subsequent therapy was similar in both groups. In the combination group, 74% received subsequent therapy (chemotherapy 56%, TKI 39%), while in the osimertinib group, 76% received subsequent therapy (chemotherapy 67%, TKI 28%).
Time to Symptomatic Progression (TTSP)
Controversy Regarding First-Line Treatment of EGFR-Mutant NSCLC:The biggest challenge for Amivantamab is its toxicity. Although the combination group can extend survival by at least 12 months, patients did not cross over to the chemotherapy-Amivantamab group. Therefore, should we "first use Osimertinib and then escalate to the chemotherapy-Amivantamab combination after resistance," or "directly adopt the two-drug combination as first-line treatment"? Should intensified treatment be considered if ctEGFR is not cleared after 4 weeks of Osimertinib treatment?
Safety
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