ADAURA Update: Adjuvant Osimertinib Maintains Overall Survival Benefit at 8 Years in EGFR-Mutated NSCLC
By: Wendy LaGrego
Posted: Friday, October 9, 2026
Long-term follow-up from the phase III ADAURA trial (NCT02511106) demonstrated a sustained overall survival benefit with adjuvant osimertinib vs placebo in patients with completely resected, epidermal growth factor receptor (EGFR)–mutated stage IB to IIIA non–small cell lung cancer (NSCLC). The findings were presented by Roy S. Herbst, MD, PhD, of the Dartmouth Cancer Center and the Geisel School of Medicine, at the International Association for the Study of Lung Cancer (IASLC) 2026 World Conference on Lung Cancer. This post hoc exploratory analysis evaluated survival outcomes approximately 8 years after randomization, extending previous findings that established 3 years of adjuvant osimertinib as a standard of care in this population.
Study Details
The global, double-blind ADAURA trial enrolled 682 patients with completely resected, EGFR-mutated stage IB to IIIA NSCLC and a World Health Organization performance status of 0/1. Patients were randomly assigned 1:1 to receive osimertinib at 80 mg once daily (n = 339) or placebo (n = 343) for up to 3 years or until disease recurrence or another discontinuation criterion was met. Adjuvant chemotherapy was permitted.
The primary endpoint was investigator-assessed disease-free survival among patients with stage II to IIIA disease; overall survival was a secondary endpoint. Previous analyses demonstrated significant improvements in disease-free survival (hazard ratio [HR] = 0.20; P < .001) and overall survival (HR = 0.49; P < .001) with osimertinib.
For the current analysis, investigators collected additional survival information through May 4, 2026, among patients alive at the January 27, 2023, data cutoff for the planned final overall survival analysis. Updated survival information was available for 431 of these 558 patients; the remaining 127 patients were censored at their last known date alive. All randomly assigned patients were included in the exploratory analysis. Overall survival rates were estimated using Kaplan-Meier methodology.
Key Results
Among patients with stage II to IIIA disease (n = 470), adjuvant osimertinib was associated with an overall survival HR of 0.53 (95% confidence interval [CI] = 0.38–0.75), based on 142 events. The estimated 8-year overall survival rate was 74% (95% CI = 67%–80%) with osimertinib vs 58% (95% CI = 50%–65%) with placebo, representing an increase of 16 percentage points. Median overall survival follow-up was 92.0 vs 68.5 months, respectively.
In the overall stage IB to IIIA population (n = 682), the overall survival HR was 0.52 (95% CI = 0.39–0.71), based on 175 events. Estimated 8-year overall survival rates were 79% (95% CI = 74%–83%) with osimertinib vs 64% (95% CI = 58%–70%) with placebo, an increase of 15 percentage points. Median overall survival follow-up was 93.3 vs 79.6 months, respectively.
An overall survival benefit with osimertinib was observed across predefined subgroups.
Conclusions
The investigators reported that this exploratory ADAURA analysis provided the longest overall survival follow-up of any global phase III trial of adjuvant therapy in EGFR-mutated NSCLC. They concluded that the additional findings further characterized the established long-term survival benefit of adjuvant osimertinib following complete resection, with or without adjuvant chemotherapy.
