Targeted therapy for non-small cell lung cancer provides benefit to patients after surgery

A clinical trial led by Yale Cancer Center shows that the drug osimertinib, a targeted therapy for non-small cell lung cancer, improved rates of survival and reduced risk of recurrence in patients after surgery.

The results, published June 4 in the New England Journal of Medicine, were presented this week by Dr. Roy Herbst, deputy director of Yale Cancer Center and principal investigator of the ADAURA Phase III clinical trial, during the 2023 annual meeting of the American Society of Clinical Oncology. Herbst is also assistant dean for translational research, ensign professor of medicine (medical oncology), and professor of pharmacology at Yale School of Medicine.

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.

ADAURA used osimertinib in the setting of lung cancer where patients already had surgery, and the results are impressive," said Herbst, who is also chief of medical oncology at Yale Cancer Center. "We're moving this effective drug therapy into the earliest stages of disease."

Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center

The randomized, double-blind, global Phase III trial assessed the safety and efficacy as well as survival outcomes following osimertinib use in patients with surgically removed EGFR-mutated NSCLC, who were previously treated with or without adjuvant chemotherapy. Trial results showed significant benefits for patients with NSCLC who had taken 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.

In the overall population of patients with stage IB to IIIA disease, the ADAURA study found osimertinib reduced the risk of death by 51%. In all, 88% of patients treated with osimertinib following surgery survived at least five years, compared to 78% of patients treated with a placebo.

"In the U.S., 10 to 15% 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. "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."