Whether Osimertinib (Tagrisso) can cure advanced lung cancer and its clinical evaluation

Osimertinib is a third-generation EGFR targeted drug, mainly used to treat patients with non-small cell lung cancer carrying EGFR mutations, including common 19 exon deletion, L858R and the drug-resistant mutation T790M. It can significantly extend survival, control tumor progression, and improve the quality of life of advanced patients. However, current medical evidence shows that although osimertinib has strong anti-tumor ability, it cannot cure most patients with advanced lung cancer. Its role is more to prolong survival time, delay disease progression and control the disease rather than to achieve complete cure, especially when distant metastasis has occurred, tumor cells usually cannot be completely eliminated.

From clinical trials and real-world data, the median progression-free survival (PFS) of osimertinib in patients with advanced EGFR mutations can reach 18—19 months, the overall survival (OS) can exceed 36 months, and some patients can even achieve long-term survival of several years. For patients with brain metastases, osimertinib has good central penetration, can reduce the risk of worsening of intracranial lesions and prolong the control time of the central system. These results reflect its important role in late-stage treatment, but still do not mean that all tumor cells can be completely eliminated. The vast majority of patients may still eventually develop disease progression due to the emergence of new drug-resistant mutations.

When evaluating whether long-term survival or even approaching a "cure" status is possiblemultiple factors need to be considered, including the type of genetic mutation, tumor burden, the presence of brain or other organ metastases, the effectiveness of the initial treatment, and the patient's overall physical condition. A small number of patients achieve extremely high remissions and maintain stability for many years after osimertinib treatment, and are sometimes called "ultra-long-term survivors", but this is not equivalent to cure in the medical sense. With the emergence of resistance mechanisms, such as MET amplification, C797S mutation, etc., subsequent combination therapy, drug change, or clinical trials are usually required.

In general, osimertinib has become one of the most important basic drugs in the treatment of advanced EGFR mutated lung cancer, which can significantly improve survival and quality of life, but it is still unable to achieve a true cure. A more realistic treatment goal is to delay the course of the disease, prolong high-quality survival as much as possible, and adjust the regimen in a timely manner when drug resistance occurs. In the future, with dual targeting, immune combination and new generation EGFR With the emergence of inhibitors, the long-term survival prospects of some patients may further improve.

Reference materials:https://www.drugs.com/