Osimertinib after surgery significantly improves survival in resected EGFR-mutated NSCLC

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Published: 5 Jun 2023
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Prof Roy Herbst - Yale Cancer Center, New Haven, USA

Dr Roy Herbst talks to ecancer at ASCO 2023 about the latest update from the ADAURA study, which found that treatment with osimertinib after surgery significantly lowered the risk of death in adults with completely resected EGFR-mutated (EGFRm) stage IB, II, or IIIA non-small cell lung cancer (NSCLC).

In this final overall survival analysis study, 88% of patients with IB–IIIA NSCLC who were given osimertinib following the removal of their tumour were still alive 5 years after surgery compared to 78% of patients treated with a placebo.

Read more here.

I’m very excited to talk about ADAURA, which is osimertinib in the adjuvant setting after complete resection in stage 1, 2 and 3a non-small cell lung cancer. This trial actually just was presented and showed survival data in a very positive way. 

Patients in this trial had complete resection, chemotherapy if appropriate, and then were randomised, all these patients being EGFR mutant patients, to osimertinib versus a placebo. The idea was could we improve outcome in patients with EGFR mutated disease and the answer is yes. 

Three years ago we showed very compelling disease free survival here at ASCO with a hazard ratio of 0.17, an 83% improvement. Updated just a few months ago – still in the 76% range with decreased metastases to organs such as the brain, liver and bone. 

Here at ASCO yesterday we showed the final overall survival analysis, which showed a hazard ratio of 0.49 or a 51% improvement in disease free survival, meaning that patients with lung cancer who have this EGFR mutation, meaning we have to screen for this early on, can then go on and get this drug. I'm very hopeful that with these data more people will get it, more medical providers will recommend it, more patients will see these data and be more willing to discuss it. Then of course, regulatory bodies have to approve it and pay for it. So it it was a very exciting ASCO day. 

There is enormous impact of these results as they now define a new standard of care around the world and lung cancer is two million cases a year around the world. So, no matter where you are, you should be screened for this EGFR mutation. In fact, you should get your lung cancer screened early so we can find it early and then these drugs have very effective use as we already saw.