Osimertinib (EGFR TKI) Sustains 8-Year OS Benefit After Resected EGFR-Mutant NSCLC

Osimertinib is a 3rd-generation, CNS-penetrant EGFR tyrosine kinase inhibitor given for 3 years after surgery for EGFR exon 19 deletion or L858R-mutant NSCLC. In this long-term update of the Phase 3 ADAURA trial (N=682), 8-year overall survival was 79% with osimertinib vs 64% with placebo across stage IB–IIIA disease (HR 0.52); among stage II–IIIA patients, OS was 74% vs 58% (HR 0.53). The benefit appeared larger for exon 19 deletion (HR 0.45) than L858R (HR 0.72), although the latter confidence interval crossed 1; the ~15–16-point survival separation is substantially larger than the historical ~4% absolute 5-year OS gain from adjuvant cisplatin-based chemotherapy.