A consensus on the role of osimertinib in non-small cell lung cancer from the AME Lung Cancer Collaborative Group

AME Lung Cancer Collaborative Group

Research output: Contribution to journalReview articlepeer-review


The first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have brought substantial clinical benefit to patients with advanced non-small cell lung cancer (NSCLC) and sensitizing EGFR mutation. However, acquired resistance is inevitable since the vast majority of patients experience disease relapse within ~1-2 years. Osimertinib is a novel irreversible, covalent third-generation EGFR-TKI and potent inhibitor of EGFR T790M mutation, the most common mechanism of acquired resistance to first-generation EGFR-TKIs. Several trials have consistently demonstrated the superior clinical activity and safety of osimertinib in patients with advanced NSCLC and acquired EGFR T790M mutation after treatment with a first-generation EGFR-TKI. Recently, the efficacy of osimertinib in a first-line setting was demonstrated to be clearly superior to standard-first line treatment in patients with EGFR-mutant NSCLC regardless of T790M mutation status. Nevertheless, this advance, several unresolved issues of osimertinib should be emphasized including the molecular mechanisms of acquired resistance to osimertinib, the feasibility of testing EGFR T790M mutation from plasma circulating tumor DNA, its efficacy to patients with central nervous system (CNS) metastases or exon 20 mutations, its combination with other therapeutic strategies such as immune checkpoint inhibitors and its role in adjuvant therapy.

Original languageEnglish
Pages (from-to)3909-3921
Number of pages13
JournalJournal of Thoracic Disease
Issue number7
Publication statusPublished - Jul 2018


  • Non-small cell lung cancer (NSCLC); osimertinib; acquired resistance; EGFR T790M

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


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