Comparing side effects of CO-1686 and AZD9291 - 1265320

wcw2012
Posts:12

Dear Dr. West and GRACE faculty,

Assuming a T790M mutation and a choice between clinical trials of CO-1686 and AZD9291, do you have a sense of whether these two drugs differ substantially in terms of their side effect profiles? A previous GRACE faculty discussion indicated that CO-1686 seems to cause hyperglycemia in about 50% of subjects. I am wondering if there are other significant differences, for example, how do the two drugs compare in terms of nausea and fatigue? If it’s not possible to compare, I would be grateful for any information regarding common side effects of either drug as actually experienced by enrolled patients.

Many thanks,

WCW

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Reply # - August 7, 2014, 09:30 PM

Dr West
Posts: 4735

In general, they are both quite well tolerated. Hyperglycemia is seen in many patients receiving CO1686 but really seems to be readily manageable with metformin, a medication for this. While some media people have made a big deal out of this, I don't think anyone who has ever managed a cancer patient has suggested it's a real problem compared with managing cancer.

AZD9291 is associated with a little more rash, in about 20-25% of patients, vs. almost none with CO1686, but again, that's really not a big deal in the context of advanced cancer.

Frankly, I would content that there is simply not enough information to say that the side effects are meaningfully worse with one than another. My preliminary impression is that these agents have pretty comparable efficacy and overall quite comparable, if a little different, tolerability.

-Dr. West

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