03490nam a2200349 4500 ESSALUD 20260821122750.0 ta t pe ||||| |||| 00| 0 spa d BMG eng Zhou, Caicun Autor 54258 First-line sunvozertinib in NSCLC with EGFR exon 20 insertion mutations páginas: 765-775 Background: Sunvozertinib received accelerated approval for use in later lines of therapy for patients with advanced non–small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 20 insertion mutations. Data are needed on the efficacy and safety of sunvozertinib as a first-line treatment for NSCLC. Methods: In this phase 3, international trial, we randomly assigned, in a 1:1 ratio, patients with advanced nonsquamous NSCLC with EGFR exon 20 insertions to receive sunvozertinib or chemotherapy (carboplatin–pemetrexed). The primary end point was progression-free survival as assessed by blinded independent central review. Crossover to the sunvozertinib group was allowed after disease progression was confirmed. Secondary end points included overall survival, investigator-assessed progression-free survival, objective response (complete or partial response), change in tumor size, and duration of response. Results: A total of 324 patients were randomly assigned to receive sunvozertinib (163 patients) or chemotherapy (161 patients). Treatment with sunvozertinib led to significantly longer median progression-free survival than chemotherapy (10.3 vs. 7.5 months; hazard ratio for disease progression or death, 0.65; 95% confidence interval, 0.50 to 0.85; P<0.001). At 12 months, progression-free survival was reported in 46.1% of the patients in the sunvozertinib group and in 26.7% of those in the chemotherapy group; the data for overall survival were immature (38.9% maturity). The percentage of patients with an objective response was 58.9% in the sunvozertinib group and 31.1% in the chemotherapy group; the median best percentage change in tumor size was −42.1% and −24.7% respectively, and the median duration of response was 11.2 and 7.1 months. Grade 3 or higher adverse events were reported in 75.5% of the patients in the sunvozertinib group and in 56.7% of those in the chemotherapy group. In the sunvozertinib group, the most common adverse events of grade 3 or higher included increased serum creatine kinase levels, diarrhea, and anemia. No deaths were attributed to adverse events considered by the investigators to be related to sunvozertinib. Conclusions: The efficacy of sunvozertinib was superior to that of chemotherapy as first-line treatment for advanced NSCLC with EGFR exon 20 insertions. CÁNCER DE PULMÓN 53712 NEUMOLOGÍA 25628 CUIDADOS INTENSIVOS GENERAL 54115 TRATAMIENTOS EN ONCOLOGÍA 53734 Greillier, Laurent 54259 Liu, Geoffrey 54260 John, Thomas 54261 Xing, Ligang 54262 Kowalski, Dariusz 54263 Memmott, Regan M. 54264 Yazici, Ozan 54265 Sun, Meili 54266 Shu, Catherine A. 54267 Pons-Tostivint, Elvire 54268 22717 22650 Massachusetts NEJM Group NEJM12 The New England Journal of Medicine ESSALUD 0028-4793 ARTICULOS 2026-08-21 sqb 22854 22854