A NEW post hoc analysis of the ADAURA trial highlights the role of osimertinib in detecting molecular residual disease (MRD) in resected EGFR-mutated stage IB–IIIA non-small-cell lung cancer (NSCLC). The study suggests that MRD assessment using circulating tumor DNA (ctDNA) can predict recurrence risk and guide treatment decisions.
The ADAURA trial established osimertinib as an effective adjuvant therapy in reducing recurrence rates in EGFR-mutated NSCLC. This latest analysis focuses on ctDNA as a biomarker for MRD, evaluating its presence in patients following complete tumor resection. Researchers collected serial plasma samples to assess MRD status and its impact on disease recurrence.
Findings reveal that patients with detectable ctDNA post-surgery had a significantly higher risk of recurrence than those without. Importantly, among MRD-positive patients, those treated with osimertinib demonstrated a reduced risk of recurrence compared to those receiving placebo. These results suggest that osimertinib may effectively target residual disease, improving long-term outcomes.
The study also highlights the importance of ongoing MRD monitoring. Patients who converted from MRD-positive to MRD-negative during treatment had a lower likelihood of recurrence, reinforcing the potential of ctDNA as a dynamic biomarker for guiding therapy.
These findings could influence clinical decision-making by integrating MRD assessment into routine practice. By identifying patients at higher recurrence risk, oncologists may optimize adjuvant treatment strategies, potentially improving survival outcomes in EGFR-mutated NSCLC.
Reference: Herbst RS et al. Molecular residual disease analysis of adjuvant osimertinib in resected EGFR-mutated stage IB–IIIA non-small-cell lung cancer. Nat Med. 2025. doi:10.1038/s41591-025-03577-y.
Anaya Malik | AMJ
