The first therapies that target mutated forms of the EGFR protein were approved for use in people with non-small cell lung cancer (NSCLC) more than 15 years ago. Updated results from a large clinical trial now show that one of the newest EGFR-targeted drugs, osimertinib (Tagrisso), is more effective than earlier EGFR-targeted therapies in people whose NSCLC tumors have specific alterations in the EGFR gene. In the trial, dubbed FLAURA, patients with advanced NSCLC who received osimertinib as an initial treatment lived approximately 7 months longer than patients treated with erlotinib (Tarceva) or gefinitib (Iressa). And the survival improvement did not come at the cost of safety; the investigators saw no increase in serious side effects in people treated with osimertinib. The trial’s overall survival results were initially presented in late September at the European Society for Medical Oncology (ESMO) annual meeting in Barcelona and were published November 21 in the New England Journal of Medicine. Osimertinib was approved by the Food and Drug Administration (FDA) in 2018 as an initial, or first-line, treatment for people with advanced NSCLC that has specific EGFR mutations. The approval was based on earlier findings from the FLAURA trial showing that the drug improved how long people lived without their cancer getting worse (progression-free survival). The finding that osimertinib also improves how long patients live overall further cements its role in treatment, said the FLAURA trial’s lead investigator, Suresh Ramalingam, M.D., of the Winship Cancer Institute of Emory University in Atlanta. In patients with advanced NSCLC whose tumors have EGFR mutations, Dr. Ramalingam said, “osimertinib is now the standard of care for first-line therapy.” Leora Horn, M.D., clinical director of the Thoracic Oncology Program at Vanderbilt-Ingram Cancer Center in Tennessee, agreed. The FLAURA results “tell us that [osimertinib] is definitely the drug you should be using first” for these patients, Dr. Horn said.