ArticleTargeted oncology2026
Real-World Outcomes of Sequential Afatinib and Osimertinib Versus Afatinib and Chemotherapy in EGFR-Mutant NSCLC: Taiwan Multicenter GIANT Study.
Article in Targeted oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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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.
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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.
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Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal treatment strategy for epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC)-sequential tyrosine kinase inhibitor (TKI) monotherapies versus upfront combination therapies-remains debated.
objectiveThe Giotrif In Advanced NSCLC Taiwan (GIANT) study evaluated the real-world outcomes of sequential afatinib-based strategies. PATIENTS AND
methodsThis multicenter retrospective cohort study included 733 treatment-naïve patients with American Joint Committee on Cancer stage IIIB-IV NSCLC harboring Del19 or L858R EGFR mutations who received first-line afatinib across seven major Taiwanese medical centers between 2016 and 2024. Patients were stratified by second-line therapy into two groups: afatinib-osimertinib (n = 303) and afatinib-chemotherapy/other lines (n = 430). The primary outcome was overall survival (OS).
resultsSequential afatinib-osimertinib therapy achieved a median OS of 55 months (95% confidence interval [CI] 53.2-66.4) compared to 32.3 months (95% CI 30.3-34.5) with alternative strategies (adjusted hazard ratio 0.43, p < 0.001). Survival benefits were consistent across EGFR mutations and brain metastasis statuses.
conclusionSequential afatinib-to-osimertinib therapy achieved remarkable OS exceeding 55 months in real-world practice, with outcomes appearing competitive with contemporary combination strategies. These findings support sequential TKI therapy as a durable and effective alternative that warrants prospective validation.
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