Summary
Phase III trial shows mobocertinib performs similarly to chemotherapy for EGFR exon 20 insertion lung cancer patients.
A major clinical trial called EXCLAIM-2 tested whether a new targeted drug called mobocertinib works better than standard chemotherapy for treating a specific type of lung cancer. The study focused on patients with non-small cell lung cancer that has a particular genetic change called EGFR exon 20 insertion mutations. This genetic change affects how cancer cells grow and is found in about 4% of lung cancer patients.
Researchers studied 354 patients whose cancer had spread and who had never received treatment before. Half the patients took mobocertinib pills once daily, while the other half received standard chemotherapy through IV infusions every three weeks for four cycles, followed by maintenance treatment.
The main goal was to see which treatment kept cancer from getting worse for a longer time. Unfortunately, both treatments worked about the same. Patients in both groups lived about 9.6 months without their cancer progressing. This means mobocertinib was not better than chemotherapy at stopping cancer growth.
However, there were some differences between the treatments. About 32% of patients taking mobocertinib saw their tumors shrink compared to 30% with chemotherapy. When tumors did respond to mobocertinib, the response lasted longer – about 12 months versus 8.4 months with chemotherapy.
Patients taking mobocertinib reported better quality of life in some areas. They had fewer lung cancer symptoms, better thinking ability, and less constipation compared to those receiving chemotherapy. The side effects were different too. Mobocertinib caused more diarrhea, while chemotherapy caused more blood-related problems like anemia and low white blood cell counts.
While mobocertinib didn’t prove superior to chemotherapy in this study, it offers patients another treatment option with different benefits and side effects, which may be important for individual treatment decisions.
