Lung cancer is the most common cause of cancer death in Australia and approximately two-thirds of patients have advanced disease at the time of diagnosis. For patients who have early stage disease and who have curative-intent surgery to remove the lung cancer, there remains a risk of the cancer returning later (recurrence). In some patients with lung adenocarcinoma (the most common form of lung cancer in Australia), the cancer is driven by a genetic mutation in a gene called ‘EGFR’. Drugs have been developed that block this pro-cancerous EGFR pathway and these have an important role in treating patients with advanced lung adenocarcinomas carrying this mutation.
In June 2023, an international team of researchers published a study in the prestigious New England Journal of Medicine showing that use of osimertinib (one such EGFR blocker) reduced the risk of recurrence of EGFR-mutant lung adenocarcinoma in patients who had already had their early-stage tumour surgically resected (https://pubmed.ncbi.nlm.nih.gov/32955177/). The overall survival at 5 years in patients receiving osimertinib was 85% versus 73% in the placebo group. This trial included 682 patients from Japan and Taiwan; it must be noted that such patients have a higher chance of having an EGFR mutation compared with the Australian population overall.
This is an important study which suggests that anti-cancer treatment can be helpful even after what has historically been considered curative resection of early stage lung cancer. Given the recency of the study, this medication is not currently available in Australia for this indication (it is available in other circumstances) but this situation may change in the future.
