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Adjuvant Osimertinib in Resected EGFR-Mutated Stage IB-IIIA Non-Small Cell Lung Cancer: Exploratory 8-year Overall Survival Landmark Update from the ADAURA Trial [161/175]

In brief

Adjuvant osimertinib raises 8-year survival to 79% versus 64% with placebo

In the ADAURA trial's long-term follow-up, patients with resected EGFR-mutated stage IB-IIIA lung cancer who received adjuvant osimertinib had an 8-year overall survival of 79%, compared with 64% for placebo-a 15-percentage-point advantage and roughly a halving of death risk. The benefit was consistent across mutation types and disease stages, supporting osimertinib as a durable adjuvant option, though the analysis remains exploratory.

Journal
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (Q1)
Published
13 September 2026
Study design
Non-randomized / quasi-experimental trial
Evidence level
Level 2, Moderate (CEBM 2b)
Authors
Yi-Long Wu, Margarita Majem, Thomas John, Christian Grohé, Jie Wang, Jonathan W Goldman, et al.
PMID
42732874
DOI
10.1016/j.jtho.2026.104179

Why clinicians should know about it

Abstract

INTRODUCTION: In ADAURA, adjuvant osimertinib improved DFS and OS versus placebo in resected EGFR-mutated stage IB-IIIA NSCLC. We report a post hoc exploratory analysis of long-term OS post-adjuvant treatment completion. METHODS: Patients (N = 682) were randomized to osimertinib or placebo until recurrence, treatment completion, or discontinuation. Updated survival data were collected from 431/558 patients alive at the planned final OS analysis (DCO, 27 January 2023) through yearly follow-up until the current DCO (4 May 2026) or from accessible records/information from last contact date after 27 January 2023. Patients without additional follow-up remained censored, survival time unchanged from the planned final OS analysis DCO (n = 127). This exploratory long-term OS analysis was conducted in all randomized patients. RESULTS: At the current DCO, in the stage II-IIIA population: OS HR was 0.53 (95% CI: 0.38-0.75); 8-year OS rates were 74% (osimertinib) versus 58% (placebo); median follow-up was 92.0 versus 68.5 months. In the stage IB-IIIA population: OS HR was 0.52 (95% CI: 0.39-0.71); 8-year OS rates were 79% (osimertinib) versus 64% (placebo); median follow-up was 93.3 versus 79.6 months. OS HRs according to EGFR Ex19del and L858R mutations were 0.45 (95% CI: 0.29-0.68) and 0.72 (95% CI: 0.46-1.11), respectively. OS benefit with osimertinib was observed across subgroups. CONCLUSIONS: With the longest OS from a global phase III adjuvant trial in EGFR-mutated stage IB-IIIA NSCLC, these additional long-term results further characterize the established survival benefit of adjuvant osimertinib. CLINICAL TRIAL INFORMATION: ADAURA (NCT02511106).

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.