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Co-led ADAURA and IPASS, the trials that made EGFR-targeted pills standard before and after surgery.
Yi-Long Wu is Professor at the Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, and a leader of the Chinese Thoracic Oncology Group. He is among the most cited lung cancer trialists in the world, co-principal investigator of ADAURA, which tested adjuvant osimertinib in resected EGFR-mutated non-small-cell lung cancer, and a leader of IPASS and ADJUVANT-CTONG, the trials that made EGFR-targeted pills standard before and after surgery. His publications include the ADAURA report on osimertinib in resected EGFR-mutated lung cancer. His interests are EGFR-mutant disease, adjuvant targeted therapy and clinical trials.
| Title | Journal | Year |
|---|---|---|
| Osimertinib in resected EGFR-mutated non-small-cell lung cancer (ADAURA) | NEJM | 2020 |
The survival benefit first reported in 2023 has held five years after the last dose of adjuvant osimertinib, which answers the worry that a three-year course only delays relapse. Patients with an exon 19 deletion gained most; the L858R estimate crosses one and is less certain. Nothing here changes the recommendation, which already rests on the 2023 analysis, but it tightens the case for testing every resected non-squamous tumour for EGFR mutations.
Every resected non-squamous lung cancer should be tested for EGFR mutations, because patients who carry one live longer if they take osimertinib for three years after surgery. The trial does not tell us whether adjuvant chemotherapy can be omitted, nor what happens on relapse after osimertinib, and the three-year duration was chosen empirically.
This is the separate paper behind the survival figure quoted for dacomitinib. It is a real but modest gain, and the US label notes that overall survival was not formally tested because the response rate comparison earlier in the testing order was not significant, so the P value is descriptive.
ARCHER 1050 supported dacomitinib's 2018 US first-line approval and was the first head-to-head win of a second-generation EGFR inhibitor over a first-generation one on progression-free survival. FLAURA, reported the same year, made osimertinib the usual first choice, so dacomitinib is now rarely used.
Shares ADAURA: exploratory eight-year overall survival update for adjuvant osimertinib in resected EGFR-mutated stage IB to IIIA lung cancer, ADAURA: three years of osimertinib after surgery for EGFR-mutated lung cancer, ADAURA, Osimertinib.
Shares Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, phase 3 trial, Improvement in overall survival in a randomized study that compared dacomitinib with gefitinib in patients with advanced non-small-cell lung cancer and EGFR-activating mutations, ARCHER 1050, ALK-positive non-small-cell lung cancer.
Shares Chinese Thoracic Oncology Group, ADAURA: exploratory eight-year overall survival update for adjuvant osimertinib in resected EGFR-mutated stage IB to IIIA lung cancer, ADAURA: three years of osimertinib after surgery for EGFR-mutated lung cancer, EGFR.
Shares Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, phase 3 trial, Improvement in overall survival in a randomized study that compared dacomitinib with gefitinib in patients with advanced non-small-cell lung cancer and EGFR-activating mutations, ARCHER 1050, EGFR.
Shares ARCHER 1050, Osimertinib, Resectable stage I to III non-small-cell lung cancer, EGFR-mutated non-small-cell lung cancer.
Shares Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, phase 3 trial, Improvement in overall survival in a randomized study that compared dacomitinib with gefitinib in patients with advanced non-small-cell lung cancer and EGFR-activating mutations, ARCHER 1050, Guangdong Provincial People's Hospital.
Shares Unresectable stage III non-small-cell lung cancer, Osimertinib, EGFR-mutated non-small-cell lung cancer, EGFR.
Shares ADAURA: three years of osimertinib after surgery for EGFR-mutated lung cancer, Unresectable stage III non-small-cell lung cancer, Osimertinib, EGFR-mutated non-small-cell lung cancer.