Se-hoon Lee, a Professor at Samsung Medical Center, recently gained attention by publishing a study on Leclaza (lazertinib, Yuhan Corp), a domestic third-generation EGFR TKI (Tyrosine Kinase Inhibitor).

With the advent of another option to the global standard therapy option Tagrisso (osimertinib) increasing the number of treatment options to two and rendering choices difficult on-site, Dailpharm met with Lee to hear his thoughts on treatment strategies that should be implemented in the clinical field?

Sehoon Lee, MD, Professor of Hematology/Oncology at Samsung Medical Center, spoke at an event hosted by AstraZeneca on the 11thto evaluate the value of Tagrisso amid the growing number of treatment options for EGFR mutation-positive non-small cell lung cancer (NSCLC).

As the event was hosted by AstraZeneca, Professor Lee first described Tagrisso as a ‘model’ treatment for the development of EGFR TKIs, starting with Iressa (gefitinib).

In particular, the recent increase in the number of patients with EGFR mutation-positive NSCLC, particularly in East Asia, has made TKIs more relevant, said Lee.

“Recently, the number of non-smoking lung cancer patients has been increasing, and many of them are EGFR mutation-positive NSCLC patients,” said Lee. “And new therapies have emerged, starting with Tagrisso. So it is now time for us to establish treatment strategies using third-generation EGFR TKIs.’

So what does Professor Lee see as the future strategy for lung cancer treatment?

In the domestic market, the addition of Tagrisso monotherapy and chemotherapy combination therapy, as well as Leclaza monotherapy as first-line treatments for NSCLC, has rendered choice difficult for clinicians who have to prescribe treatments.

At the same time, the US FDA has approved the Leclaza+Rybrevant combination therapy, and this may soon be approved in the domestic market as well.

When asked about the differences between the two drugs, Professor Lee described the current situation as a ‘complex era’. While he considers Tagrisso to be the standard option, he also sees the newer drug as being in an ‘equal’ position.

In other words, Tagrisso's position as a standard option remains unwaivered, even though the Leclaza+Rybrevant combination is recommended as first-line therapy in the NCCN guidelines.

“I presented a study on Leclaza at the World Congress of Lung Cancer (WCLC), and we carefully discussed the evaluated study results with the sponsor, Janssen, to clarify the wording and terminology,’ says Lee. ’The gist of the presentation was that there was a possibility that lasertinib+amivantamab may be more beneficial.”

He also noted the OS data for Tagrisso+chemotherapy, which is approved in Korea but is currently only available on a non-reimbursed basis.

“Tagrisso monotherapy demonstrated a median overall survival of 38.6 months in the first-line treatment of EGFR-mutated NSCLC.” said Lee, adding that “Tagrisso+chemotherapy showed a significant PFS extension effect compared to monotherapy, despite the inclusion of more than twice as many patients with central nervous system metastases.”

‘The combination showed a significant improvement in survival over Tagrisso monotherapy, with a PFS of 24.9 months in patients with central nervous system metastases and 24.7 months in patients with the L858R mutation,” said Lee. ’While the data are still immature, the widening gap in OS data is now being observed, and we look forward to seeing the final data.”