Osimertinib monotherapy and Osimertinib plus chemotherapy in patients with epidermal growth factor receptor (EGFR)-mutated advanced Non-Small Cell Lung Cancer

Authors

• RoseMarie Casanova, Virginia University of LynchburgFollow

Specialty

Oncology

Advisor

Dr. Luis Rodriguez

Abstract

Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), remains the established first-line standard for EGFR-mutated non–small cell lung cancer (NSCLC) due to its superior CNS penetration and favorable safety profile. However, the inevitable emergence of acquired resistance has intensified the clinical focus on osimertinib-based combination strategies. This review synthesizes evidence from randomized trials and observational cohorts to compare the efficacy of osimertinib monotherapy against emerging combination regimens, evaluating key outcomes such as progression-free survival (PFS), overall survival, and treatment-related toxicity. While monotherapy offers robust PFS with a manageable side-effect profile, data suggest that combination therapies particularly those incorporating chemotherapy may offer significant advantages for high-risk subgroups, including patients with high disease burden or specific molecular co-mutations. Consequently, clinical decision-making must be highly individualized, balancing the potential for deepened responses against the increased risk of adverse events. By providing an evidence-based framework to navigate these evolving first-line strategies, this review assists clinicians in optimizing therapeutic sequences and improving long-term patient survival.  Key words: EGFR-mutated, non-small cell lung cancer, osimertinib, tyrosine kinase inhibitor (TKI), combination therapy, resistance mechanisms

Recommended Citation

Casanova R. Osimertinib monotherapy and Osimertinib plus chemotherapy in patients with epidermal growth factor receptor (EGFR)-mutated advanced Non-Small Cell Lung Cancer. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).