The ADVANCE trial randomised patients with unresectable EGFR-mutated stage III non-small cell lung cancer to aumolertinib plus definitive radiotherapy or cisplatin/pemetrexed with radiotherapy, and was stopped early at a planned interim analysis after 43 of 98 patients were enrolled. Median progression-free survival was 34.0 months in the aumolertinib arm against 7.4 months in the chemoradiotherapy arm (HR 0.15); median overall survival was not reached against 30.5 months (HR 0.32, p=0.09). A prespecified real-world cohort of 125 patients found similar results with a tyrosine kinase inhibitor added to radiotherapy, whether concurrent with chemotherapy or not.
Why it is interesting: Tests whether a targeted agent can replace chemotherapy alongside radiotherapy in a genomically selected lung cancer subgroup, on a progression endpoint with overall survival still immature.