Long-term data from the phase 3 ADAURA trial, presented at the 2026 World Conference on Lung Cancer, demonstrates that adjuvant osimertinib provides sustained survival benefits for patients with resected EGFR-mutated non–small cell lung cancer. This finding reinforces osimertinib’s position as a standard treatment for this patient group. Given that non–small cell lung cancer accounts for the majority of lung cancer diagnoses, these results have significant implications for oncology practice.
Eight-Year Survival Outcomes
An exploratory analysis of the ADAURA trial included 682 patients with completely resected stage IB, II, or IIIA EGFR-mutated NSCLC, who were randomly assigned to receive either osimertinib 80 mg once daily or placebo for up to three years. Adjuvant chemotherapy was permitted at the discretion of the treating physician. In patients with stage II to IIIA disease, osimertinib was associated with a 47% reduction in the risk of death compared to placebo (HR, 0.53; 95% CI, 0.38-0.75). The estimated 8-year overall survival rate was 74% for osimertinib and 58% for placebo, representing a 16-percentage-point difference.
Among the broader population of patients with stage IB to IIIA disease, osimertinib reduced the risk of death by 48% (HR, 0.52; 95% CI, 0.39-0.71). The 8-year overall survival rates were 79% for the osimertinib group and 64% for the placebo group. It is notable that some patients in the placebo group crossed over to osimertinib after recurrence, which may have narrowed the observed difference between the treatment arms. The safety profile of osimertinib remained consistent with its established profile, with no new safety signals identified.
Pharmacists can play a key role in optimizing outcomes for patients with EGFR-mutated NSCLC by confirming the documentation and communication of EGFR mutation status prior to adjuvant therapy decisions. They can also proactively monitor for adverse effects, screen for potential drug interactions due to osimertinib’s cytochrome P450 3A4 metabolism, and regularly assess patients for side effects at critical points during the three-year treatment course. This proactive approach can help mitigate the risk of non-adherence, particularly in the later stages of treatment.
Persistence and Real-World Outcomes
The updated results from the ADAURA trial do not alter the current standard of care, which already recommends three years of adjuvant osimertinib for patients with resected EGFR-mutated NSCLC. A separate real-world analysis presented at the same conference found that patients who discontinued osimertinib before completing the three-year course had more than twice the risk of disease recurrence or death compared to those who completed treatment. While this analysis was retrospective and cannot establish causality, it shows the potential impact of pharmacists on treatment outcomes by promoting adherence to the full treatment regimen.
