Should we consider radiation therapy for patients with N2 EGFRm NSCLC who will receive osimertinib, though RT was excluded on ADAURA?

For an EGFR-mutant N2 disease, we favor adjuvant chemotherapy (OS benefit) and/or adjuvant TKI based on ADAURA trial (DFS survival). The only prospective data regarding the use of adjuvant radiotherapy comes from a phase III trial, Lung Adjuvant Radiotherapy Trial (Lung-ART), where patients were ran...

Regardless of ADAURA or osimertinib, this could be a very easy question to answer given the LungART trial data presented recently at ESMO 2020 and the fact that there has never been a randomized trial of post-operative radiation therapy (PORT) that has demonstrated an overall survival benefit in pat...

No, the trial was positive without radiation. The recent Lung ART trial did not show any benefit for post-operative radiation, so I would avoid that.

The benefit of adjuvant radiation for N2 disease has not been proven with the same level of evidence as the question of adjuvant chemotherapy.

I may be less likely to pursue adjuvant radiation in a patient to get adjuvant osimertinib. However, if an N2+ patient is receiving radiation, I would still...