The latest analysis of Janssen's NEJ009 clinical trial is reported in Journal of Clinical Oncology (JCO), a leading journal of the American Academy of Clinical Cancer. The combination of zepitinib and carboplatin/pemetrexid chemotherapy in advanced non-small cell lung cancer patients with EGFR mutations showed significantly better therapeutic effects compared to the zepitinib alone group.

A total of 242 patients were randomly assigned to the Zepitinib group and the Zepitinib+carboplatin/Pemetrexid group. In the Zepitinib+carboplatin/Pemetrexid group, the combination therapy was administered six times for three weeks, and then the Zepitinib+Pemetrexid maintenance therapy was used, excluding carboplatin.

Among the target patients, the second-line treatment of treatment with other drugs after treatment failure was 89% in the 74% Zepitinib + Carboplatin/Pemetrexid group, and the third-line treatment was 66% in the 52% Zepitinib group in the Zepitinib + Carboplatin/Pemetrexid group.

As a result of the evaluation of treatment effectiveness, the median value of progression-free survival was 32.5 months in the Zepitinib + carboplatin / pemetrexid treatment group, which was much better than 20.7 months in the Zepitinib group. Since most of the target patients received second and third-line treatment with other drugs after treatment failure, the median value of overall survival was 49 months in the zepitinib + carboplatin / pemetrexid treatment group and 38.5 months in the zepitinib alone treatment group, showing no statistical difference.

Researchers showed an improved progression-free survival period in combination with zepitinib and carboplatin/pemetrexid chemotherapy in non-small cell lung cancer patients with EGFR mutations compared to zepitinib monotherapy, but various new drugs are being developed and the combination of EGFR blockers and neovascular inhibitors is very effective, so the optimal order of treatment through comparative clinical trials should be established in the future.

Reference: Updated Analysis of NEJ009: Gefitinib-Alone Versus Gefitinib Plus Chemotherapy for Non–Small-Cell Lung Cancer With Mutated EGFR. Journal of Clinical Oncology 2022 In press