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2023 ASCO: Highlights of Lung Cancer Research

*June 2023*


The biggest lung cancer news to be presented at this year’s meeting was the final 5-year survival results of the ADAURA trial. This trial, the first of its kind, looked at the use of adjuvant (after surgery) osimertinib (a third-generation targeted therapy for EGFR-positive lung cancer) in patients who had undergone surgery for EGFR-positive non-small cell lung cancer (NSCLC). The 5-year overall survival rate was 88% in patients treated with osimertinib compared to 78% among patients who did not receive the drug.

Despite these promising results, we still have some unanswered questions. While osimertinib is the gold standard TKI (tyrosine kinase inhibitor) treatment in the US and many parts of the world for patients whose tumors test positive for EGFR ex19del or EGFR L858R metastatic NSCLC, it is likely that these early-stage tumors will eventually develop resistance to osimertinib, as they do for other TKI treatments. Therefore, it’s even more critical to determine what’s next after osimertinib. Furthermore, we need to figure out better ways to identify which patients will need adjuvant osimertinib, since there is a group of patients who did well even without osimertinib.

Researchers are working on developing other treatments that would work in combination with osimertinib or as a single drug to help treat patients whose tumors have developed TKI resistance. The SYMPHONY trial aims to overcome osimertinib resistance using BLU-945, a next-generation TKI that showed promising results in terms of safety and side effects. Additional studies are ongoing to continue testing this treatment approach.

The results from the KEYNOTE-789 trial, a phase 3 study looking at adding immunotherapy (pembrolizumab) to chemotherapy in patients with TKI-resistant EGFR-positive NSCLC, showed no significant benefit to adding the immunotherapy. These results, along with others, suggest that more work is needed to understand how immunotherapy can be leveraged to benefit patients with EGFR-positive NSCLC.  Read more.