Dr. Kris on the RELAY Trial in EGFR+ NSCLC

Mark G. Kris, MD, medical oncologist, William and Joy Ruane Chair in Thoracic Oncology, Memorial Sloan Kettering Cancer Center, discusses the RELAY trial, which was an international, double-blind, randomized phase III study examining erlotinib (Tarceva) in combination with ramucirumab (Cyramza) versus placebo in previously untreated patients with EGFR-mutant metastatic non-small cell lung cancer (NSCLC).

Previous data suggest that adding bevacizumab (Avastin) to erlotinib potentially lengthens the time to relapse by 6 months compared with erlotinib alone. The RELAY trial shows that if a different drug targeting angiogenesis is used, in this case ramucirumab, there is potential for a delay in time to relapse. In the study, relapse was delayed by approximately 7 months.

Ramucirumab is widely available; however, erlotinib is not a commonly used drug. Kris explained that osimertinib (Tagrisso) could be substituted in place of erlotinib, but there are varying opinions. There are other trials evaluating the use of bevacizumab with osimertinib. The optimal EGFR TKI and VEGF inhibitor combination for patients with metastatic NSCLC will be worked out in years to come, Kris concludes.