Osimertinib improves survival after surgery for non-small cell lung cancer

Osimertinib improves survival and reduces recurrence in non-small cell lung cancer.

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In the ADAURA study, patients with EGFR-mutated, stage IB to IIIA NSCLC experienced significantly longer disease-free life with adjuvant osimertinib therapy than with placebo.

A new study conducted by a Yale Cancer Center researcher finds that patients with non-small cell lung cancer (NSCLC) who get osimertinib (TAGRISSO), a targeted medication, after surgery have better survival rates and a lower chance of recurrence.

The research, published in the New England Journal of Medicine, focused on individuals with NSCLC who had an epidermal growth factor receptor (EGFR) mutation.

Roy Herbst, MD, Ph.D., lead author and principal investigator of the ADAURA trial, said, “ADAURA used osimertinib in lung cancer where patients already had surgery, and the results are impressive. We’re moving this effective drug therapy into the earliest stages of the disease.”

Dr. Herbst, deputy director of Yale Cancer Center and assistant dean for translational research at Yale School of Medicine, presented findings at the annual American Society of Clinical Oncology meeting in Chicago, Illinois, 2023.

The phase III trial looked at the safety, effectiveness, and survival outcomes of osimertinib in patients with surgically removed (totally resected) stage IB-IIIA NSCLC who had previously received adjuvant chemotherapy or not.

Patients with NSCLC who took osimertinib had significantly longer disease-free Survival (DFS) than placebo, a lower risk of local and distant metastases (tumor spread), and improved central nervous system DFS.

The ADAURA trial found that 88% of patients with stage IB-IIIA non-small cell lung cancer treated with osimertinib following surgery were alive five years later, compared to 78% of patients treated with a placebo.

Dr. Herbst, who also is an Ensign Professor of Medicine (Medical Oncology) at Yale School of Medicine, said, “In the U.S., 10 to 15 percent of patients with lung cancer will have mutations in the epidermal growth factor receptor, and these patients, even after they receive the best available therapy, their tumor still often comes back, We’re now adding osimertinib, a pill that targets this specific receptor, and what we’ve found is a significant overall survival benefit for patients who received osimertinib.”

This study’s findings support using osimertinib as a highly effective treatment in patients with resected EGFR-mutated stage IB-IIIA non-small cells lung cancer.

Dr. Herbst said, “When we treat cancer early, we prevent cancer from spreading to the brain, to the liver, to the bones.”

He added, “In this trial, we took advantage of the efficacy of osimertinib, used it earlier, and resulted in a phenomenal impact on Survival. That’s practice-changing, and it helps people live longer with lung cancer. I’m very excited to be part of this research.”

The conclusion shows that Patients with totally resected, EGFR-mutated, stage IB to IIIA NSCLC benefited significantly from adjuvant osimertinib in terms of overall Survival.

The research was funded by AstraZeneca, ADAURA.

Journal Reference:

  1. Masahiro Tsuboi, M.D., Roy S. Herbst, et al.Overall Survival with osimertinib in Resected EGFR-Mutated NSCLC. The new england journal of Medicine. DOI: 10.1056/NEJMoa2304594
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