FLAURA2 Principal Investigator Shares Insights on Final OS Analysis

FLAURA2 Principal Investigator, Pasi A. Jänne, MD, PhD, joined Lung Cancers Today to discuss the final overall survival (OS) analysis from the trial.

The final OS analysis of the trial showed that osimertinib plus pemetrexed and platinum-based chemotherapy demonstrated a “statistically significant and clinically meaningful improvement” in OS compared with osimertinib monotherapy as first-line treatment for locally advanced or metastatic EGFR-mutated non–small cell lung cancer (NSCLC), according to a July 21, 2025, announcement from AstraZeneca.

“It’s previously been published that the combination led to an improvement in progression-free survival and delayed recurrence of lung cancer, but today’s announcement really takes it to the next level, demonstrating that this combination also improves overall survival, which is the goal for our patients with advanced lung cancer,” Dr. Jänne told Lung Cancers Today.

Dr. Jänne, who is senior vice president for Translational Medicine and a thoracic medical oncologist at Dana-Farber Cancer Institute, reflected on what these results mean for patients, clinicians, and the field as a whole.

“The findings are significant, both from a trial design and statistical standpoint, but are really clinically significant and impressive,” Dr. Janne said. “I think treating physicians and patients alike will agree with me that it’s a significant improvement compared to what we have seen in the past. Having patients be able to be treated with an effective regimen and one that leads to a prolonged survival is welcome in this space.”

With single-agent osimertinib being an established standard of care in this setting, Dr. Jänne explained what clinicians and patients should consider when deciding between monotherapy and combination therapy.

“Some may still choose single-agent osimertinib; some may want to choose a combination. Combinations lead to better outcomes, but they do come at a cost of more side effects and having to come into the clinic for intravenous infusions,” Dr. Jänne said.

This means that it’s critical to have “an informed discussion with the patient discussing the various choices that are available today and which one he or she would like to pursue as initial treatment,” he explained. Dr. Jänne emphasized that the goal is to not only prolong survival but to ensure that the therapy is tolerable.

“It’s important to maintain a good quality of life while still receiving active therapy for one’s cancer,” Dr. Jänne said.

For those who pursue the combination of osimertinib plus pemetrexed and platinum-based chemotherapy, Dr. Jänne explained that oncologists should be alert for common chemotherapy side effects and employ chemotherapy side effect management strategies when needed. It’s also important to be aware of the cumulative fatigue that can occur with continuous chemotherapy, he said.

“There are different strategies to manage that with dose interruptions, dose reductions, or dose delays that we commonly employ in clinical practice,” Dr. Jänne said.

He also spoke about what the trial findings suggest about using osimertinib in combination versus in sequence.

“Findings from the trial suggest that maybe it is important to combine effective therapies from the beginning, as that clearly has led to an improvement in overall survival, as opposed to giving them sequentially,” Dr. Jänne said. “There may be some synergistic benefit to giving combination therapies upfront as opposed to sequentially. But I think [there will be] more to come on that as we learn more about the details of the trial and learn about results of other ongoing and future trials in this space. This will continue to be an active area to find novel and new combinations with osimertinib to see what kind of results can be obtained and whether they’re similar [to] or better than what we have seen today.”

He also reflected on how far the field has come and why it’s critical to keep evaluating new treatment strategies and combinations.

“We’ve had EGFR inhibitors for EGFR-mutant lung cancer for quite some time, but the progress had plateaued a little bit once we had osimertinib, which was superior to prior EGFR inhibitors,” Dr. Jänne said. “But now the opportunity is to build upon that success, and this is one approach—using these different combinations—to build upon that success to make the outcomes even better.”