For patients with previously untreated advanced non-small cell lung cancer (NSCLC) with an EGFR mutation, overall survival is longer for treatment with osimertinib rather than comparator tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKIs), according to a study published online in the New England Journal of Medicine.

Suresh S. Ramalingam, M.D., from the Emory University School of Medicine in Atlanta, and colleagues randomly assigned 556 patients with previously untreated advanced NSCLC with an EGFR mutation to receive either osimertinib or one of two other EGFR-TKIs (gefitinib or erlotinib) combined into a single comparator group.

The researchers found that the median overall survival was 38.6 and 31.8 months in the osimertinib and comparator groups, respectively (hazard ratio for death, 0.80; 95.05 percent confidence interval, 0.64 to 1.00; P = 0.046). At three years, 28 and 9 percent of patients in the osimertinib and comparator groups, respectively, were still receiving a trial regimen; median exposure was 20.7 and 11.5 months, respectively. Forty-two percent of patients in the osimertinib group and 47 percent in the comparator group had adverse events of grade 3 or higher.

"We found that first-line treatment with osimertinib was associated with significantly longer overall survival than treatment with comparator EGFR-TKIs in patients with EGFR mutation-positive, locally advanced or metastatic NSCLC and had a similar safety profile," the authors write.

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