After complete resection, a small but significant survival benefit has been seen with platinum-basedadjuvant chemotherapy 補助化学療法 for patients with stage II to IIIA disease.
As adjuvant therapy 補助療法, first-generation EGFR-TKIs are not associated with a survival benefit among patients with NSCLC who have EGFR wild-type or amplified tumors.
The EVAN trial showed a longer disease-free survival at 2 years with adjuvanterlotinib than with chemotherapy among patients with EGFR mutation–positive stage IIIA tumors.
In the ADJUVANT/CTONG1104 trial involving patients with stage II to IIIA EGFR mutation–positive NSCLC, the median disease-free survival among patients in the intention-to-treat population who received adjuvant gefitinib was significantly longer than that among patients who received chemotherapy and disease-free survival was higher at 3 years, although this benefit did not translate to an overall survival advantage.
Wu and colleagues now report in the Journal the results of the phase 3, double-blind, randomized ADAURA trial of osimertinib as adjuvant therapy administered for 3 years after complete resection in patients with stage IB to IIIA EGFR mutation–positive NSCLC.
EGFR-TKIs plus chemotherapy are currently being studied as neoadjuvant therapy in patients with EGFR mutation–positive stage II to IIIB disease and as first-line therapy in patients with EGFR mutation–positive metastatic disease. https://www.nejm.org/doi/full/10.1056/NEJMe2029532
