{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:57:30Z","timestamp":1790618250600,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K08CA279653"],"award-info":[{"award-number":["K08CA279653"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      FLAURA2 demonstrated that adding chemotherapy to osimertinib improved overall survival compared with osimertinib monotherapy in metastatic\n                      <jats:italic>epidermal growth factor receptor<\/jats:italic>\n                      \u2010mutated (\n                      <jats:italic>EGFR<\/jats:italic>\n                      \u2010mut) non\u2010small\u2010cell lung cancer (NSCLC). Notably, only 60% of patients in the osimertinib monotherapy arm received second\u2010line therapy after discontinuing first\u2010line osimertinib. Aims We hypothesized that a higher proportion of patients on osimertinib monotherapy receive second\u2010line therapy at academic medical centers in the United States (US).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      This is a retrospective cohort study of 115 patients with metastatic\n                      <jats:italic>EGFR<\/jats:italic>\n                      \u2010mut NSCLC treated with first\u2010line osimertinib monotherapy at an academic medical center in the United States from February 2018 to July 2024. Analyses included Kaplan\u2013Meier survival estimation, log\u2010rank test, multivariate Cox regression, Wilcoxon rank\u2010sum test, and Fisher's exact test. Most patients were female (74%) and had a history of never\u2010smoking (69%); 50% were Asian, and 93% of patients had adenocarcinoma histology. The median time to treatment failure (TTF) for all patients on first\u2010line osimertinib was 25.3\u2009months (95% CI: 18.6\u201337.5). The median TTF was 15.7\u2009months (CI: 13.1\u201322.0) for patients with\n                      <jats:italic>TP53<\/jats:italic>\n                      \u2010mut disease and 42.2\u2009months (CI: 36.9\u2013NR) for patients with\n                      <jats:italic>TP53<\/jats:italic>\n                      wild\u2010type tumors (log\u2010rank test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Of the 115 total patients, 66 (57.4%) discontinued first\u2010line osimertinib. Of these 66 patients, 26 (39.4%) either died or pursued hospice. Forty (60.6%) of the 66 patients experienced progression of disease and subsequently received second\u2010line therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Only 61% of patients with metastatic\n                      <jats:italic>EGFR<\/jats:italic>\n                      \u2010mut NSCLC received second\u2010line therapy after osimertinib at our institution, similar to the second\u2010line therapy rates in the control arm of FLAURA2.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70693","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:20:14Z","timestamp":1790205614000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Second\u2010Line Therapy Following Osimertinib in Metastatic\n                    <scp>\n                      <i>EGFR<\/i>\n                    <\/scp>\n                    \u2010Mutated Non\u2010Small\u2010Cell Lung Cancer at an Academic Medical Center"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9136-4624","authenticated-orcid":false,"given":"Michael","family":"Rafizadeh","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4075-8100","authenticated-orcid":false,"given":"Stephanie","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of 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