Should 3 years of adjuvant osimertinib be the standard of care for resected Stage IB-IIIA EGFRm NSCLC?

Since my initial response to this question, the ADAURA study has been fully published (NEJM 383:1711, 2020) and the FDA has approved osimertinib as adjuvant therapy for people with resected NSCLC harboring an EGFR sensitizing mutation. However, neither of these events has altered my opinion that des...

Adjuvant or neoadjuvant TKIs for those with driver alterations will not be standard until there is evidence that they improve cure rate or prolong survival. Look at the long term results of CTONG 1104 at ASCO 2020 showing no survival advantage for erlotinib although there was prolonged DFS.

In my opinion, yes. I realize there has been quite a lot of debate on this topic and academic thoracic oncologists have differing opinions. I agree that in the ideal situation, adjuvant therapies should be judged on their ability to prolong overall survival. This is the only endpoint which demonstra...

I believe so. Of course, the recommendation to the patient comes with a careful discussion. At this point, we only have a proven disease free survival benefit, and I do describe to patients that it is possible that osimertinib upon recurrence could lead to the same overall survival as adjuvant use. ...

For patients with stage II or III disease, I believe adjuvant Osimertinib (after adjuvant chemotherapy) should be standard of care for most patients. The data on reduction in DFS is quite compelling. The HR of 0.2 is unprecedented in lung cancer trials (and in any intervention in the post-op setting...

Yes, the ADAURA trial planned for a maximum of 3 years of treatment. While the trial is still early, I would base my decisions on the results of this study as we await longer-term outcome and survival.