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Looks like Osimertinib, Aztrazenica's 17k a month drug, will present adjuvant data in EGFRm+ NSCLC at #ASCO

Before even reading the paper, let me tell you how to critically appraise it [Thread]
If the trial has a DFS benefit without an OS benefit, that is not good enough

We won't know if we are merely delaying inevitable metastatic recurrence vs. actually curing people

Targeted TKIs don't do well in the adjuvant setting at increasing cure rates
If the trial has an OS benefit, look at the EGFR drugs given to the control arm

It better NOT BE gefitinib.

If you compare adjuvant osi to gefitinib at recurrence you are running a straw man trial.

The same PI who gives Osi frontline, can't accept gefitinib to control arm
If the trial has an OS benefit, and the control arm got appropriate frontline EGFR therapy, double check second line therapy.

Make sure second line therapy is also appropriate.
My fear is we will have a DFS benefit without an OS benefit

When the control arm progresses they will get gefitinib and

Second line therapy will be beneath global best care.

We have to be vigilant

If this happens, the trial should go in the dustbin w other failed adj studies
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