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There were a couple other interesting observations in that trial. One is that patients who had chemotherapy at the time of diagnosis had an 11-month improvement in progression-free survival. That is counterintuitive because people have this idea in their head that chemotherapy doesn't really work well with brain metastases, but clearly it does, and it did here.
Years ago, I attended a lecture by Zosia Piotrowska, from Massachusetts General Hospital. She is one of the brightest people in the world when it comes to this disease. Somebody asked her during the question-and-answer session,"If you could do something today to improve the outcome in people withI wholeheartedly agree. Many of you who know me know I've been recommending chemotherapy with osimertinib ever since those original publications with gefitinib, and I continue to do that.
We have a new treatment that improves progression-free survival, which is very important to patients. We know we can safely deliver carboplatin and pemetrexed, and I urge you to discuss it with every patient, and, in my opinion, to recommend it to every patient who is fit.
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