Thread by @StephenVLiu

#ESMO20 Randomized phase II study of osimertinib alone or with bevacizumab in #EGFR T790M NSCLC by Prof Yukihiro Toi (West Japan Oncology Group 8715L). #LCSM @OncoAlert

#ESMO20 After a 6 patient lead-in, patients randomized 1:1 to osimertinib 80mg alone or with bevacizumab 15mg/kg q3w. Primary endpoint here was PFS. #LCSM @OncoAlert

#ESMO20 81 patients randomized, 22-30% with brain metastases. Slight imbalance in del19 vs L858R. Given the known biologic differences between these mutations, I do think we need to stratify for specific mutation in randomized studies going forward. #LCSM @OncoAlert

#ESMO20 Addition of bevacizumab to osimertinib improved RR from 55% to 71.8%, but not PFS. mPFS with osimertinib was 13.5m (slightly overperformed compared to AURA) while mPFS with osi + bev was 9.4m (HR 1.44) with similar trend across subgroups, worst if prior anti-VEGF given.

#ESMO20 Time to treatment failure better with osimertinib alone compared to osi + bevacizumab. OS similar in the two arms. While some toxicities more frequent with bev (proteinuria, HTN), hard to explain the differences. Osimertinib alone remains the standard. #LCSM