ESMO 2025: Targeted therapy plus radiation or surgery improves outcomes in patients with advanced lung cancer
MD Anderson Research News October 17, 2025
Lung cancer is the leading cause of cancer-related death worldwide, with non-small cell lung cancer (NSCLC) the most common form
Approximately 15% of NSCLC patients have mutant EGFR, which drives cancer growth
Osimertinib blocks mutant EGFR, targeting against exon 19 deletion and L858R, the two most common EGFR mutations
Patients treated with osimertinib plus radiation or surgery did not see their cancer progress for more than two years, on average
BERLIN, OCTOBER 17, 2025 ¨C Pairing radiation or surgery with osimertinib in patients with EGFR-mutant non-small cell lung cancer (NSCLC) decreased the risk of cancer progression by 34% compared to osimertinib alone, according to new research from Â鶹ӳ» MD Anderson Cancer Center.
The results of the Phase II?randomized NorthStar study found that progression-free survival (PFS) was significantly increased, from a median of 17 months with osimertinib alone to 25.4 months with the combination approach. The updated data were presented today at the s () by principal investigator , associate professor of Thoracic/Head and Neck Medical Oncology.
Why are the findings from the NorthStar trial important??
While osimertinib is considered the standard of care for EGFR-mutant metastatic NSCLC, the benefits of adding radiation or surgery ¨C or both ¨C to further prolong survival in patients receiving targeted therapy have been unclear.
¡°For patients with EGFR-mutant non-small cell lung cancer, adding the targeted therapy osimertinib alongside these other treatments not only helped prevent progression of the primary tumor, but also metastatic sites,¡± Elamin said. ¡°This is an encouraging step forward and suggests osimertinib could become a valuable therapeutic addition for these patients.¡±
How was the NorthStar trial designed??
The trial enrolled 119 patients with EGFR-mutant metastatic NSCLC. All patients received 80 mg. of osimertinib daily for six to 12 weeks. After that period, those without any disease progression were randomized to continue with osimertinib alone (63) or receive radiation (33), surgery (17), or radiation plus surgery (6).
In addition to seeing cancer progression under control for an extended amount of time, the combination treatment was found to be safe, with no unexpected side effects.
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This trial was funded by the National Comprehensive Cancer Network and AstraZeneca. For a full list of collaborating authors, disclosures and funding sources, read the .
For patients with EGFR-mutant non-small cell lung cancer, adding the targeted therapy osimertinib alongside these other treatments not only helped prevent progression of the primary tumor, but also metastatic sites. This is an encouraging step forward and suggests osimertinib could become a valuable therapeutic addition for these patients.