Osimertinib, the winner, but cannot yet take it all

Osimertinib is a potent, irreversible EGFR-TKI, selective for EGFR T790M mutation as well as EGFR sensitizing mutations (1). In series of AURA trials, osimertinib has shown significant activity for T790M mutation positive patients who had shown disease progression in previous EGFR-TKI treatment (2). The randomized phase III AURA3 trial comparing osimertinib to standard pemetrexedplatinum- doublet chemotherapy in T790M mutation positive patients demonstrated that osimertinib had superior progression-free survival (PFS) of 10.1 months compared to chemotherapy with PFS of 4.4 months [hazard ratio (HR) 0.30; 95% confidence interval (CI), 0.23–0.41; P<0.001].