PEOPLE TREATED WITH a combination of chemotherapy and the targeted therapy Tagrisso (osimertinib) for advanced EGFR-positive non-small cell lung cancer (NSCLC) lived longer than those treated with Tagrisso alone, according to a new study. The findings provide more information for doctors and people with EGFR-positive lung cancer choosing between multiple options for first-line treatment.

Cancer cells with a mutation on the EGFR gene produce abnormally high amounts of the EGFR protein, which signals the cells to grow and multiply uncontrollably. Tagrisso blocks the protein on cancer cells and can stop cancer from growing. The Food and Drug Administration (FDA) originally approved Tagrisso for EGFR-positive NSCLC in 2015 and approved Tagrisso on its own as the first treatment for people with metastatic disease in 2018.

In the phase III FLAURA2 trial, 557 people with advanced EGFR-positive NSCLC received either Tagrisso with chemotherapy or Tagrisso alone. Both Tagrisso and platinum-based chemotherapy are standard treatments for advanced EGFR-positive NSCLC.

In findings published Oct. 17, 2025, in the New England Journal of Medicine, the Tagrisso and chemotherapy combination resulted in longer median overall survival, the length of time people in the study lived after starting treatment. The overall survival in the combination group was 47.5 months versus 37.6 months for the group receiving Tagrisso alone.

Researchers had already found that the Tagrisso-chemotherapy combination extended how long people on the treatment went before the cancer progressed based on an earlier analysis of this trial but were enthused by the new findings that confirmed it also extended life. “A median overall survival of almost four years is the longest ever seen in a phase III clinical trial in this subset of patients,” says Pasi A. Jänne, the study’s lead author and a medical oncologist and director of the Chen-Huang Center for EGFR Mutant Lung Cancers at Dana-Farber Cancer Institute in Boston. “Knowing that Tagrisso plus chemotherapy also improves overall survival makes the findings even more robust,” Jänne says.

In the new study, 70% of the patients in the Tagrisso plus chemotherapy group experienced treatment side effects that required medical attention compared with 34% of the patients in the Tagrisso-only group. The most common side effects people experienced were diarrhea, nausea, decreased appetite, constipation, rash, fatigue and vomiting and were usually minor. Most of the higher-grade side effects that required medical intervention were low blood cell levels, such as anemia and neutropenia. People taking Tagrisso should also be monitored for certain serious side effects, including interstitial lung disease or pneumonitis, heart failure, and eye and skin problems that require immediate attention.

“It’s ironic that chemotherapy is being added back to a targeted therapy, which adds back some of the side effects of chemotherapy, but for the most part, it’s a win,” says Roy S. Herbst, a medical oncologist and the deputy director of the Yale Cancer Center in New Haven, Connecticut, who was not involved in the research. “A median overall survival improvement of 10 months makes Tagrisso plus chemotherapy a new standard of care.”

The combination regimen adds to the first-line treatment options, such as the targeted FDA-approved combination therapy of Rybrevant (amivantamab) and Lazcluze (lazertinib), available to patients with advanced EGFR-positive NSCLC.

Discuss the treatment options for advanced EGFR-positive NSCLC and how they fit with your overall health with your doctor. People should consider the balance of potential benefits compared with the side effects, the logistics of undergoing treatment, and prognostic factors. For example, “the combination of Tagrisso and chemotherapy may be particularly beneficial for patients with EGFR-positive advanced NSCLC that has spread to the central nervous system,” Jänne says. “Chemotherapy added to Tagrisso improves overall survival in patients with and without known baseline brain metastases, but it appears to be greater in patients with baseline brain as well as liver and brain metastases. For these patients, we would want to think about this combination approach.” The three-year overall survival for people with metastases in the central nervous system was 57% for people given the combination and 40% in people given Tagrisso alone.

It’s important to weigh the pros and cons of each treatment and factor in what’s most important to you. People who can’t tolerate chemotherapy may opt for Tagrisso alone, which involves simply taking a daily pill. “It’s tough when you have multiple options, trying to figure out which is the right one for each individual patient, but treatment options are exciting. It’s a good problem to have,” Jänne says.

Sandra Gordon is a medical writer in Stamford, Connecticut.