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Lung: ADAURA - disease-free survival magnitude

Free question published 16 October 2026

RespiratoryADAURA - disease-free survival magnitude

At an MDT a trainee asks how large the disease-free survival benefit of adjuvant osimertinib was in the ADAURA trial for the overall stage IB-IIIA EGFR-mutated population. Which figure most accurately reflects the reported hazard ratio for disease-free survival?

  1. AHazard ratio 0.62
  2. BHazard ratio 0.80
  3. CHazard ratio 0.95
  4. DHazard ratio 0.20
  5. EHazard ratio 1.18

Why D is correct

In ADAURA the disease-free survival hazard ratio in favour of osimertinib was 0.20 in the stage IB to IIIA population, a striking reduction in the risk of recurrence or death that drove the trial's early unblinding and subsequent overall survival benefit (OS HR 0.49).

And why the others are not

  • A0.62 is the order of effect seen with first-line immunotherapy trials such as KEYNOTE-024, not the ADAURA DFS hazard ratio.
  • B0.80 substantially understates the magnitude of benefit reported in ADAURA.
  • C0.95 would imply almost no benefit, contradicting the ADAURA result.
  • E1.18 implies harm and is the CONVERT once-daily versus twice-daily figure, not ADAURA.

Source ADAURA - Adjuvant osimertinib in resected EGFR-mutated stage IB-IIIA NSCLC — Tsuboi M, Herbst RS, John T, et al. Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC. N Engl J Med. 2023;389(2):137-147. (ADAURA; primary DFS: Wu YL et al, N Engl J Med 2020;383:1711-1723).

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