{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:03Z","timestamp":1786115763186,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of adjuvant almonertinib versus icotinib in patients with resected stage II-IIIA epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 80 patients treated with adjuvant almonertinib or icotinib after complete resection. Disease-free survival (DFS) was the primary endpoint; secondary endpoints included overall survival (OS) and safety. Multivariate Cox regression was used to identify factors associated with DFS and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were well balanced. After a median follow-up of 40.0\u202fmonths, almonertinib demonstrated a significant DFS advantage (HR\u202f=\u202f0.36, 95% CI: 0.16\u20130.82), with the median DFS not reached versus 29.0\u202fmonths for icotinib (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0142). The 24-month DFS rates were 85.1 and 61.2%, respectively. Subgroup analyses showed consistent benefits in male patients, patients younger than 65\u202fyears, patients with stage IIIA disease and those with smoking history. OS also favored almonertinib (HR\u202f=\u202f0.43, 95% CI: 0.19\u20130.94), with the median OS not reached versus 41.2\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0355). Recurrence occurred in 17.5% of the almonertinib group and 45.0% of the icotinib group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0150). The 24-month central nervous system (CNS) metastasis-free survival rate reached 100% in the almonertinib group versus 96.6% in the icotinib group; however, the total number of CNS metastatic events was very small (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f3), so this numerical difference should only be interpreted as an exploratory trend rather than definitive evidence of CNS protection. Safety profiles were comparable, although grade \u22653 TEAEs were less frequent with almonertinib (7.5% vs. 25.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0367). No TEAEs or TRAEs leading to death were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective cohort, adjuvant almonertinib was associated with significantly improved DFS and OS, recurrence prevention, and a more favorable safety profile compared with icotinib. A numerical trend of reduced CNS metastasis was observed, but limited CNS events preclude firm conclusions regarding CNS protective activity. A tentative early OS survival trend favoring almonertinib was observed, but OS data remain immature with limited death events; long-term follow-up is needed to verify this potential survival benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1891244","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:27Z","timestamp":1785994347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of almonertinib as adjuvant therapy in stage II-IIIA EGFR-mutant non-small cell lung cancer: a retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Tingting","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Medical Technology, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracoscopic Surgery, Cangzhou Central Hospital","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuezhen","family":"An","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Cangzhou Central Hospital","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cangzhou Central Hospital","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zefen","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cangzhou People's Hospital (Cangzhou Medical College Affiliated Hospital)","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiutong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Cangzhou Medical College","place":["Cangzhou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1200\/JCO.22.02186","article-title":"Adjuvant osimertinib for resected EGFR-mutated stage IB-IIIA non-small-cell lung cancer: updated results from the phase III randomized ADAURA trial","volume":"41","author":"Herbst","year":"2023","journal-title":"J Clin Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e057098","DOI":"10.1136\/bmjopen-2021-057098","article-title":"Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: a Bayesian network meta-analysis","volume":"12","author":"Pang","year":"2022","journal-title":"BMJ Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"78985","DOI":"10.18632\/oncotarget.12587","article-title":"The prevalence of EGFR mutation in patients with non-small cell lung cancer: a systematic review and meta-analysis","volume":"7","author":"Zhang","year":"2016","journal-title":"Oncotarget"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"102724","DOI":"10.1016\/j.ctrv.2024.102724","article-title":"Neoadjuvant EGFR-TKI therapy in non-small cell lung cancer","volume":"126","author":"Grant","year":"2024","journal-title":"Cancer Treat Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/S2213-2600(23)00183-2","article-title":"Befotertinib (D-0316) versus icotinib as first-line therapy for patients with EGFR-mutated locally advanced or metastatic non-small-cell lung cancer: a multicentre, open-label, randomised phase 3 study","volume":"11","author":"Lu","year":"2023","journal-title":"Lancet Respir Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/S2213-2600(21)00134-X","article-title":"Icotinib versus chemotherapy as adjuvant treatment for stage II-IIIA EGFR-mutant non-small-cell lung cancer (EVIDENCE): a randomised, open-label, phase 3 trial","volume":"9","author":"He","year":"2021","journal-title":"Lancet Respir Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.2147\/OTT.S290636","article-title":"Icotinib versus cisplatin plus docetaxel as adjuvant chemotherapy in patients with stage II (N1+) non-small cell lung cancer harboring positive EGFR mutations: a single-center retrospective study","volume":"14","author":"Pan","year":"2021","journal-title":"Onco Targets Ther"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"898586","DOI":"10.3389\/fonc.2022.898586","article-title":"Double-dose icotinib may induce the emergence of the EGFR exon 20 T790M mutation in non-small cell lung cancer patients harboring EGFR-sensitive mutation","volume":"12","author":"Chen","year":"2022","journal-title":"Front Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12913-025-13958-1","article-title":"An updated cost-effectiveness analysis of osimertinib versus placebo in resected EGFR-mutated non-small cell lung cancer: the perspective of the United States","volume":"26","author":"Chen","year":"2026","journal-title":"BMC Health Serv Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/ijc.IJC_455_19","article-title":"Management of CNS metastases in patients with EGFR mutation-positive NSCLC","volume":"56","author":"Shetty","year":"2019","journal-title":"Indian J Cancer"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.jtho.2021.10.024","article-title":"Efficacy of aumolertinib (HS-10296) in patients with advanced EGFR T790M+ NSCLC: updated post-national medical products administration approval results from the APOLLO registrational trial","volume":"17","author":"Lu","year":"2022","journal-title":"J Thorac Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S1470-2045(25)00643-6","article-title":"Aumolertinib as adjuvant therapy in resected EGFR-mutated non-small-cell lung cancer (ARTS): a double-blind, multicentre, randomised, controlled, phase 3 trial","volume":"27","author":"Zhang","year":"2026","journal-title":"Lancet Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/jjco\/hyae073","article-title":"The effect of epidermal growth factor receptor mutation on adjuvant chemotherapy with tegafur\/uracil for patients with completely resected, non-lymph node metastatic non-small cell lung cancer (>2 cm): a multicenter, retrospective, observational study as exploratory analysis of the CSPOR-LC03 study","volume":"54","author":"Miyoshi","year":"2024","journal-title":"Jpn J Clin Oncol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2418","DOI":"10.21037\/tlcr-22-345","article-title":"Adjuvant chemotherapy for completely resected IIA-IIIA non-small cell lung cancer: compliance to guidelines, safety and efficacy in real-life practice","volume":"11","author":"D\u00e9sage","year":"2022","journal-title":"Transl Lung Cancer Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"471","DOI":"10.3390\/diagnostics14050471","article-title":"NUF2 expression in cancer tissues and lymph nodes suggests post-surgery recurrence of non-small cell lung cancer","volume":"14","author":"Shirakami","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s12964-024-01678-8","article-title":"GLUT1 promotes cell proliferation via binds and stabilizes phosphorylated EGFR in lung adenocarcinoma","volume":"22","author":"Zhou","year":"2024","journal-title":"Cell Commun Signal"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1200\/JCO.20.01820","article-title":"Gefitinib versus vinorelbine plus cisplatin as adjuvant treatment for stage II-IIIA (N1-N2) EGFR-mutant NSCLC: final overall survival analysis of CTONG1104 phase III trial","volume":"39","author":"Zhong","year":"2021","journal-title":"J Clin Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3912","DOI":"10.1200\/JCO.22.00428","article-title":"Updated overall survival and exploratory analysis from randomized, phase II EVAN study of erlotinib versus vinorelbine plus cisplatin adjuvant therapy in stage IIIA epidermal growth factor receptor+ non-small-cell lung cancer","volume":"40","author":"Yue","year":"2022","journal-title":"J Clin Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"354","DOI":"10.6004\/jnccn.2025.0043","article-title":"NCCN guidelines\u00ae insights: non-small cell lung cancer, version 7.2025","volume":"23","author":"Riely","year":"2025","journal-title":"J Natl Compr Cancer Netw"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.annonc.2022.02.003","article-title":"ESMO expert consensus statements on the management of EGFR mutant non-small-cell lung cancer","volume":"33","author":"Passaro","year":"2022","journal-title":"Ann Oncol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1056\/NEJMoa2304594","article-title":"Overall survival with osimertinib in resected EGFR-mutated NSCLC","volume":"389","author":"Tsuboi","year":"2023","journal-title":"N Engl J Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1746932","DOI":"10.3389\/fmed.2026.1746932","article-title":"Individualized duration of adjuvant alectinib therapy and rechallenge efficacy in ALK-positive non-small cell lung cancer: a case report","volume":"13","author":"Chen","year":"2026","journal-title":"Front Med (Lausanne)"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"100621","DOI":"10.1016\/j.jtocrr.2023.100621","article-title":"Adjuvant osimertinib in patients with stage IB to IIIA EGFR mutation-positive NSCLC after complete tumor resection: ADAURA China subgroup analysis","volume":"5","author":"Wang","year":"2023","journal-title":"JTO Clin Res Rep"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"4007","DOI":"10.1200\/JCO.2015.61.8918","article-title":"Adjuvant erlotinib versus placebo in patients with stage IB-IIIA non-small-cell lung cancer (RADIANT): a randomized, double-blind, phase III trial","volume":"33","author":"Kelly","year":"2015","journal-title":"J Clin Oncol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e20690","DOI":"10.1016\/j.heliyon.2023.e20690","article-title":"Afatinib overcoming resistance to icotinib and osimertinib in NSCLC with leptomeningeal metastasis in patients with acquired EGFR L858R\/T790M or L858R\/S768I mutations: two case reports","volume":"9","author":"Li","year":"2023","journal-title":"Heliyon"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1519849","DOI":"10.3389\/fphar.2025.1519849","article-title":"Adverse event profiles of EGFR-TKI: network meta-analysis and disproportionality analysis of the FAERS database","volume":"16","author":"Shi","year":"2025","journal-title":"Front Pharmacol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1132854","DOI":"10.3389\/fonc.2023.1132854","article-title":"Adjuvant EGFR-TKI therapy in resected EGFR-mutation positive non-small cell lung cancer: a real-world study","volume":"13","author":"Liu","year":"2023","journal-title":"Front Oncol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1891244\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:28Z","timestamp":1785994348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1891244\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":27,"alternative-id":["10.3389\/fmed.2026.1891244"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1891244","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"1891244"}}