New approach for Lung cancer management shares by prof. Mohammed Sabry Alkady
NorthStar Trial — ESMO 2025
Local Consolidative Therapy + Osimertinib Improves PFS in EGFR-Mutant NSCLC
Design
🧬 Phase III study including EGFR ex19del / L858R / T790M patients with non-progressive disease after Osimertinib induction.
Participants were randomized to:
• Osimertinib + LCT (surgery / radiotherapy / both) n = 56
• Osimertinib alone n = 63
Results (LBA72, ESMO 2025 – Berlin)
• Median PFS: 25.3 m vs 17.5 m
• HR 0.66 (p = 0.025) → ≈ 34 % risk reduction
• Benefit across subgroups:
• 3 metastases: 20.7 vs 15.9 m (HR 0.73)
• ex19del: 39.8 vs 22.8 m (HR 0.58)
• L858R: 19.1 vs 11.0 m (HR 0.60)
• Comprehensive LCT: 33.1 vs 15.1 m (HR 0.42)
Safety
💠 Only 3 grade 3 LCT-related AEs (pneumonitis, arterial injury, empyema) → generally well tolerated.
Interpretation — Dr Marina Garassino (U Chicago)
“Highly provocative data showing a 34 % risk reduction — a valuable addition for patients who are not candidates for chemo or amivantamab combinations.”