Firmonertinib in advanced non-small cell lung cancer with epidermal growth factor receptor P-loop and αC-helix compressing mutations.
Xiuning Le, Jie Wang, Yan Yu et al.
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In 30 seconds
The phase 1b FURTHER study evaluated first-line firmonertinib in patients with metastatic EGFR P-loop and αC-helix compressing (PACC)-mutant non-small cell lung cancer. Patients were randomized to 160 mg or 240 mg daily. Confirmed objective response rates were 43% and 68%, respectively; median progression-free survival was 11.1 and 16.0 months. Median duration of response was not reached with 160 mg and was 14.6 months with 240 mg. The findings support further study of firmonertinib in this molecular subgroup.
Key findings
- Confirmed objective response rates were 43% with 160 mg and 68% with 240 mg firmonertinib.
- Median progression-free survival was 11.1 months with 160 mg and 16.0 months with 240 mg.
- Among patients with baseline brain metastases, intracranial objective response rate was 47% (8/17).
- Treatment-related adverse events led to dose reductions in 19% and 24%, and discontinuation in 3% and 0%, respectively.
Why it matters
EGFR PACC mutations define a structurally distinct NSCLC subgroup with limited treatment options. These early clinical results indicate antitumour activity with firmonertinib, including intracranial responses, and provide a rationale for further evaluation. The response and progression-free survival results are clinically informative but come from a phase 1b study and should be interpreted as preliminary.
What to keep in mind
This was a phase 1b study with 25 and 22 patients in the two dose groups; the abstract supports further study rather than establishing comparative efficacy.