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Study Shows Osimertinib Improves Survival Following Surgery for Non-Small Cell Lung Cancer

June 04, 2023

A new study led by Yale Cancer Center shows improved rates of survival and reduced risk of recurrence in patients with non-small cell lung cancer taking osimertinib (TAGRISSO), a targeted therapy, following surgery.

Non-small cell lung cancer (NSCLC), the most common type of lung cancer, tends to recur when diagnosed at advanced stages, which makes treatment challenging.

The study, published on June 4 in the New England Journal of Medicine, focused on patients with NSCLC with a mutation in the epidermal growth factor receptor (EGFR) gene.

“ADAURA used osimertinib in the setting of lung cancer where patients already had surgery, and the results are impressive,” said Roy S. Herbst, MD, PhD, lead author and principal investigator of the ADAURA trial. “We’re moving this effective drug therapy into the earliest stages of disease.” Herbst, deputy director of Yale Cancer Center and assistant dean for translational research at Yale School of Medicine, presented the findings today during a plenary session at the 2023 American Society of Clinical Oncology annual meeting in Chicago. His presentation was simultaneous with the journal publication.

The phase III trial assessed the safety and efficacy as well as survival outcomes following osimertinib use in patients with surgically removed (completely resected) stage IB-IIIA NSCLC, who were previously treated with or without adjuvant chemotherapy. Results from the trial showed significant benefits for patients with NSCLC taking osimertinib, including prolonged disease-free survival (DFS) over placebo, reduced risk of local and distant metastases (spread of tumor), and improved central nervous system DFS.

Of the 682 patients with stage IB-IIIA NSCLC enrolled in the trial, 88% of patients treated with osimertinib following surgery were still alive five years later compared to 78% of patients treated with a placebo. The data from this study supports osimertinib as a highly effective treatment in patients with resected EGFR-mutated stage IB-IIIA non-small cell lung cancer.

“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,” said Herbst, who also is an Ensign Professor of Medicine (Medical Oncology) at Yale School of Medicine. “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.”

“When we treat the cancer early, we prevent the cancer from spreading to the brain, to the liver, to the bones,” said Herbst. “In this trial, we took advantage of the efficacy of osimertinib, used it earlier, and it resulted in a really 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 ADAURA trial was supported by AstraZeneca, the manufacturer of osimertinib.