Osimertinib is effective as first-line treatment for EGFR-positive advanced NSCLC.

This trial was carried out to compare osimertinib (Tagrisso) with other EGFR inhibitors to examine its effectiveness in treating advanced non-small cell lung cancer (NSCLC). The authors found that this treatment was effective in increasing survival without cancer worsening in these patients. 

NSCLC is responsible for around 85% of all lung cancer diagnoses. While there are many treatment options such as chemotherapy, radiation therapy, and surgical removal of tumors, NSCLC that has spread remains difficult to treat. Some NSCLCs grow in response to a protein that helps cancer cells grow and spread faster called EGFR.

Some targeted therapies such as osimertinib work by blocking signals to EGFR. This helps shrink cancer cells and stops them from multiplying. The effectiveness of osimertinib in comparison to other EGFR inhibitors in the treatment of NSCLC is still under investigation.

There were 136 patients in this trial. 71 of these patients received 80mg once daily osimertinib. The remaining 65 received another EGFR inhibitor such as gefitinib (Iressa) 250mg once daily. Patients were followed up every year for 3 years.

Patients receiving osimertinib had a longer survival without cancer worsening (17.8 months) compared to gefitinib (9.8 months). Osimertinib was associated with a 44% higher chance of not having disease progression compared to gefitinib. The average length of survival was 33.1 months in the osimertinib group. This was compared to 25.7 months in the gefitinib group. 

The most common side effects experienced in both treatment groups were low blood cell counts. Severe side effects were more common in the osimertinib group (54%) than in the gefitinib group (28%).

The authors found that osimertinib was effective in improving survival without disease worsening in patients with advanced EGFR-positive NSCLC.

This was a secondary analysis from a global study on a Chinese population. This trial was funded by AstraZeneca, the manufacturers of osimertinib and gefitinib.