Can osimertinib cure patients with advanced lung cancer?

As a targeted therapy, Osimertinib is widely used to treat patients with EGFR mutation-positive non-small cell lung cancer (NSCLC). Its application has achieved significant clinical effects, especially in advanced patients. Its original purpose of research and development is to overcome the drug resistance problem caused by the T790M mutation of the first and second generation EGFR-TKIs, thereby prolonging the survival time of patients and improving the quality of life. However, whether patients with advanced lung cancer can be "cured" is still a very cautious topic in the medical community.

From a current medical perspective, osimertinib brings more "long-term control" rather than "radical cure" effects to most patients with advanced NSCLC. The so-called "cure" usually means the complete elimination of cancer cells from the body and the absence of recurrence. Lung cancer, especially metastatic or stage IV non-small cell lung cancer, is a systemic disease in nature. Even if there is a complete response on imaging, there are still tiny residual lesions that are difficult to detect and eradicate. Therefore, the therapeutic goal of osimertinib is to prolong progression-free survival (PFS) and overall survival (OS) and improve the possibility of tumor-bearing survival.

However, the clinical effects of osimertinib are indeed surprising in some patients. For example, some patients with EGFR mutations have significantly reduced tumors and significantly improved symptoms after receiving osimertinib treatment. Some cases even remain progression-free for a long time, and some patients survive for more than five years, which was almost unimaginable in the past. Especially in patients with brain metastases, osimertinib can penetrate the blood-brain barrier and show a significant central nervous system remission rate, improving the treatment bottleneck of this type of advanced and complex disease.

However, it must be emphasized that the heterogeneity and evolution of tumors determine that even if they are initially sensitive to osimertinib, they may become resistant to it later due to new mutations or activation of bypass signaling. Therefore, osimertinib is not the "ultimate drug", but a crucial link in the treatment path for lung cancer. After patients develop drug resistance, they still need to continue to manage their condition through genetic retesting, line switching, and combination regimens.

Reference materials:https://go.drugbank.com/drugs/DB09330