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. 2025 Apr 25:16:51-55.
doi: 10.2147/LCTT.S520833. eCollection 2025.

LAURA Completes the Osimertinib Treatment Jigsaw Puzzle of EGFR+ NSCLC from Stage IB to IV: Adjuvant Osimertinib Significantly Improves PFS and CNS Progression in Unresectable Stage III EGFR-Mutated NSCLC Compared to Placebo (LAURA, NCT03521154)

Faustine X Luo  1   2 , Zhaohui Arter  1   2 , Sai-Hong Ignatius Ou  1   2 , Misako Nagasaka  1   2   3
Affiliations

LAURA Completes the Osimertinib Treatment Jigsaw Puzzle of EGFR+ NSCLC from Stage IB to IV: Adjuvant Osimertinib Significantly Improves PFS and CNS Progression in Unresectable Stage III EGFR-Mutated NSCLC Compared to Placebo (LAURA, NCT03521154)

Faustine X Luo et al. Lung Cancer (Auckl). .

Abstract

The current standard of care for unresectable stage III non-small cell lung cancer (NSCLC) involves a concurrent platinum-based doublet chemotherapy and chest radiotherapy, followed by consolidative therapy with durvalumab, an anti-programmed death ligand 1 (PD-L1) antibody, based on the PACIFIC trial (NCT02125461). However, the utility of durvalumab in EGFR-mutated lung cancer patients is questionable based on post-hoc analysis and multi-institutional retrospective analysis. Osimertinib is a third-generation EGFR-tyrosine kinase inhibitor (TKI) with proven clinical efficacy in NSCLC. Given that durvalumab showed no benefit in unresectable Stage III EGFR-mutated NSCLC, it is exciting that most recently, the LAURA trial has demonstrated promising outcomes with adjuvant osimertinib in unresectable, stage III EGFR-mutated NSCLC after definitive chemoradiotherapy with significant improvement in PFS compared to placebo. Furthermore, the LAURA trial demonstrates that osimertinib has a protective effect against distant metastases and CNS progression in this patient population. Here, we explore the results of the LAURA trial and how it transforms the standard-of-care treatment for patients with unresectable, stage III EGFR-mutated NSCLC moving forward.

Keywords: chemoradiation; consolidation therapy; epidermal growth factor receptor; stage III; tyrosine kinase inhibitor.

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Conflict of interest statement

Dr. Sai-Hong Ou reports stock ownership of Nuvalent, MBrace Therapeutics, and BlossomHill Therapeutics; stock options of Nuvation Bio, outside the submitted work. Dr. Misako Nagasaka reports personal fees from AstraZeneca, Daiichi Sankyo, Pfizer, Lilly, Genentech, Regeneron, Boehringer Ingelheim, Caris Life Sciences, Takeda, Johnson and Johnson/Janssen, Mirati/BMS; travel support from AnHeart/Nuvation Bio, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Timeline of the development and approval of osimertinib in different settings.
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