Osimertinib—first or second line for epidermal growth factor (EGFR) mutation-positive non-small cell lung cancer?

Epidermal growth factor (EGFR) M+ non-small cell lung cancer (NSCLC) accounts for about 10% of non-squamous NSCLC in Europe and North America and as much as 40% in women in Asian countries (1). For advanced disease, chemotherapy was commonly employed and achieved remission durations of 12 months at a cost of considerable toxicity, but with the development of the EGFR tyrosine kinase inhibitors gefitinib and erlotinib, targeted therapy gradually replaced chemotherapy in second line and more recently first line in EGFR M+ cancer, although the majority of the initial studies were carried out in Asian patients (2). In general these therapies were associated with a lower incidence of side effects compared to chemotherapy