Benjamin J. Solomon, MBBS, PhD

“Outcomes for patients with early-stage non–small cell lung cancer [NSCLC] remain poor despite potentially curative surgery and adjuvant cisplatin-based chemotherapy,” said formal abstract discussant Benjamin J. Solomon, MBBS, PhD, of Peter MacCallum Cancer Centre and the University of Melbourne.

Dr. Solomon continued: “The primary outcomes of ADAURA with osimertinib were promising for disease-free survival, with a staggering hazard ratio of 0.17 in the II to IIIA population and 0.20 in the entire study population, which led to the approval of adjuvant osimertinib in 98 countries. About 2 years later, the disease-free survival hazard ratio was similar, and a reduction in central nervous system metastasis was reported.”

According to Dr. Solomon, the answer to the question of whether osimertinib improved overall survival is a resounding ‘yes.’ “The survival results [of ADAURA] are practice-changing—if practice had not already changed based on the impressive disease-free survival benefit and the effect on central nervous system relapse previously reported,” he noted.

“It is essential to test all patients with early-stage lung cancer for EGFR mutations to determine the optimal treatment strategy and to discuss management within a multidisciplinary team,” Dr. Solomon stated. Although for patients without EGFR mutations, approaches such as neoadjuvant chemoimmunotherapy may be suitable, patients with EGFR mutations who have resected tumors should receive osimertinib, he added. n

DISCLOSURE: Dr. Solomon has received honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, Pfizer, and Roche/Genentech; has served as a consultant or advisor to Amgen, AstraZeneca, BeiGene, Bristol Myers Squibb, GlaxoSmithKline, Janssen, Lilly, Merck Sharp & Dohme, Novartis, Roche/Genentech, and Pfizer; and has received research funding from Sanofi.