Observational studyThe oncologist2022
First-Line Osimertinib in Patients with EGFR-Mutant Advanced Non-Small Cell Lung Cancer: Outcome and Safety in the Real World: FLOWER Study.
Observational study in The oncologist, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 60 citations in OpenAlex.
- Trial
- First-line osimertinib in advancedESMO real world data and digital oncology · 2026Article
- Second-Line Therapy Following Osimertinib in Metastatic EGFR-Mutated Non-Small-Cell Lung Cancer at an Academic Medical Center.Cancer reports (Hoboken, N.J.) · 2026Article
- Efficacy and safety of first-line osimertinib in Chinese patients with EGFR-mutated advanced non-small cell lung cancer: a prospective, multicenter, non-interventional study (FLOURISH).Cancer biology & medicine · 2026Observational
- Real-world clinical experience with osimertinib in advanced EGFR-mutated non-small cell lung cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Observational
- Cancer Drug Development in Never-Smoker Lung Cancer: Targeted and Immune-Based Therapeutic Strategies.Oncology research · 2026Review
- Efficacy of Almonertinib Versus Osimertinib as the First-Line Treatment for Non-Small Cell Lung Cancer With EGFR L858R Mutation and Prognostic Analysis: A Retrospective Comparative Cohort Study.Cancer medicine · 2025Article
- Real-World Experience of First-Line Osimertinib in EGFR Mutated Non-Small Cell Lung Cancers from a Tertiary Cancer Center, India.South Asian journal of cancer · 2025Article
- The OPEN trial-from the darkness, comes light.Translational lung cancer research · 2025Article
- Upfront osimertinib and as sequential therapy in patients withTranslational lung cancer research · 2025Article
- Risk Factors Associated with Suboptimal Real-World Outcomes in Patients with EGFR-Mutated Non-Small Cell Lung Cancer Treated with Front-Line Recommended Therapy.Advances in therapy · 2025Observational
- Healthcare resource utilization and associated cost in patients with metastatic non-small cell lung cancer treated in the immunotherapy era.The oncologist · 2025Article
- Data analytics for real-world data integration in TKI-treated NSCLC patients using electronic health records.ESMO real world data and digital oncology · 2025Article
- Rebiopsy Enhances Survival with Afatinib vs. Osimertinib in EGFR Exon 19 Deletion Non-Small Cell Lung Cancer: A Multicenter Study in Taiwan.Current oncology (Toronto, Ont.) · 2025Article
- Anlotinib added to third generation EGFR tyrosine kinase inhibitor therapy for advanced NSCLC patients with oligo-progression: a retrospective study (ALTER-L058).Frontiers in pharmacology · 2025Article
- First-Line Aumolertinib inOncology research · 2025Observational
- Review
- Osimertinib in Patients With Treatment-Naive EGFR-Mutant Non-small Cell Lung Cancer: Overall Survival, Post-progression Management and Budget Impact Analysis in Real-World.The oncologist · 2024Observational
- Real-World Analysis of Post-Progression Treatment Patterns and Outcomes forCurrent oncology (Toronto, Ont.) · 2024Article
- Osimertinib Plasma Trough Concentration in Relation to Brain Metastases Development in Patients With AdvancedJTO clinical and research reports · 2024Article
Corrections and comments
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Authors and funding
22 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOsimertinib became the standard treatment for patients with untreated EGFR-mutant advanced non-small cell lung cancer (aNSCLC) following results reported in the phase III randomized FLAURA trial. Because of strict exclusion criteria, patient populations included in pivotal trials are only partially representative of real-world patients.
methodsWe designed an observational, prospective, multicenter study enrolling patients with EGFR-mutant aNSCLC receiving first-line osimertinib to evaluate effectiveness, safety, and progression patterns in the real-world.
resultsAt data cutoff, 126 White patients from nine oncology centers were included. At diagnosis, 16 patients (12.7%) had a performance status (PS) ≥2 and 38 (30.2%) had brain metastases. Overall response rate (ORR) was 73%, disease control rate (DCR) 96.0%. After a median follow-up of 12.3 months, median time to treatment discontinuation (mTTD) was 25.3 months, median progression-free-survival (mPFS) was 18.9 months and median overall survival (mOS) was not reached (NR). One hundred and ten patients (87%) experienced adverse events (AEs), 42 (33%) of grade 3-4, with venous thromboembolism (VTE) as the most common (n = 10, 7.9%). No difference in rates of VTE was reported according to age, PS, comorbidity, and tumor load. We observed longer mTTD in patients without symptoms (NR vs. 18.8 months) and with fewer than three metastatic sites at diagnosis (NR vs. 21.4 months). Patients without brain metastases experienced longer mPFS (NR vs. 13.3 months). No difference in survival outcome was observed according to age, comorbidity, and type of EGFR mutation. Isolated progression and progression in fewer than three sites were associated with longer time to treatment discontinuation (TTD).
conclusionOsimertinib confirmed effectiveness and safety in the real world, although thromboembolism was more frequent than previously reported.
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