{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:09:22Z","timestamp":1792638562665,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although rebiopsy at progression on osimertinib is recommended for patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC), its real-world impact on clinical outcomes remains unclear. Rebiopsy on Osi is a multicenter, retrospective study assessing rebiopsy patterns, resistance mechanisms, and their impact on second-line treatment choices and outcomes in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 457 patients with advanced NSCLC harboring a common EGFR mutation (exon 19 deletion or L858R) who progressed on first-line osimertinib were identified from the Italian ATLAS registry. Patients were stratified according to rebiopsy status (tissue and\/or plasma-based next-generation sequencing) and receipt of biomarker-driven adaptive second-line therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rebiopsy was performed in 206 patients (45.1%), predominantly via tissue sampling (66.2%). A resistance mechanism was identified in 80 cases (38.8%), with higher detection rates with tissue rebiopsy (46.6%) than with liquid biopsy (13.5%). MET amplification\/overexpression emerged as the most frequent actionable resistance mechanism. Among 239 patients treated with second-line therapy, 39 (16.3%) received adaptive treatment, including 29 of 39 patients (74.3%) with MET amplification\/overexpression who were treated with a MET-TKI-based regimen. Median progression-free survival (PFS) and overall survival (OS) were longer with adaptive therapy (7.3 and 14.1\u2009months) than with rebiopsy without treatment adaptation (6.5 and 12.2\u2009months) or no rebiopsy (5.1 and 8.2\u2009months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In real-world practice, rebiopsy identifies a resistance mechanism in slightly more than one third of patients, with actionable MET amplification\/overexpression accounting for approximately one fifth of cases. Biomarker-driven adaptive therapy may improve clinical outcomes, supporting the implementation of rebiopsy in routine practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag285","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:43:59Z","timestamp":1784893439000},"source":"Crossref","is-referenced-by-count":1,"title":["EGFR-mutant NSCLC progressing on first-line osimertinib: rebiopsy in real-world and impact of second-line therapies (the \u201cRebiopsy on Osi\u201d study)"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1665-3367","authenticated-orcid":false,"given":"Eleonora","family":"Gariazzo","sequence":"first","affiliation":[{"name":"Medical Oncology, Santa Maria della Misericordia Hospital, University of Perugia , Perugia, PG 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