Abstract

FLAURA study did not disclose the prolonged OS in Asian subgroup (HR 1.00). On the contrary, in Japanese subgroup, OS was lower for osimertinib arm (HR 1.39). To date, no clinical trials exist comparing the survival between 2nd and 3rd generation EGFR-TKIs. Therefore, we have planned a randomized controlled trial to explore our hypothesis that 1st line afatinib might be superior to 1st line osimertinib in regard to OS in Japanese population. Also, we have planned to examine the differential effects of afatinib and osimertinib on systemic immunity by serial PBMC collection and subsequent immune monitoring to identify subsequent effectiveness of ICI and cytotoxic chemotherapy combination.

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