Reasons for recurrence after adjuvant osimertinib in surgically removed EGFR-mutated lung cancer
Official title: Investigation of REcurrence Mechanisms to Adjuvant osimertINib in Radically Resected EGFR-mutated NSCLC Patients - REMAIN Study
Run by Gruppo Oncologico Italiano di Ricerca Clinica · NCT07363252 · Data updated 2026-11-12
This project looks for genetic and clinical reasons why people with EGFR-mutated lung cancer who had surgery and adjuvant osimertinib later had their cancer come back, using tissue and blood samples taken at recurrence.
Quick facts
| Study type | Observational |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 100 (estimated) |
| Sponsor | Gruppo Oncologico Italiano di Ricerca Clinica Academic / other |
| Drugs / interventions | osimertinib |
| Locations | 25 sites (Bari, BA and 24 other locations) |
| Status | Recruiting |
| Started | April 14, 2026 |
| Main results expected | December 2028 |
| Study ends | December 2028 |
| Registry record updated | April 22, 2026 |
| Trial ID | NCT07363252 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18) with radically resected stage IB–IIIA EGFR-activating mutation NSCLC who received adjuvant osimertinib and experienced relapse during or after that therapy, and who have a tissue and/or liquid biopsy from the time of recurrence and can give consent.
✕Probably not a fit
Patients without an available tissue or liquid biopsy at recurrence, with concurrent active non-NSCLC malignancies treated within the past two years, or who never received adjuvant osimertinib are unlikely to benefit from this project.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This is a multicenter retrospective-prospective observational study of adults with radically resected stage IB-IIIA EGFR-mutated non-small cell lung cancer who received adjuvant osimertinib and subsequently relapsed either during treatment or after stopping it. Clinical data including demographics, comorbidities, and treatment outcomes will be collected for each patient. Centrally performed next-generation sequencing (NGS) will analyze tissue and/or liquid biopsies obtained at the time of recurrence, and NGS will also be run on surgical tissue where available. Patients may be enrolled at or after the time of recurrence and samples from participating Italian centers will be processed centrally for molecular profiling.
Why it matters
Potential benefit: If successful, the study could identify common resistance mechanisms after adjuvant osimertinib that help doctors choose better follow-up therapies and design future trials.
How similar studies have gone: Prior molecular studies in advanced EGFR-mutant NSCLC have identified both EGFR-dependent and EGFR-independent resistance mechanisms to osimertinib, but comprehensive NGS profiling specifically at adjuvant recurrence remains limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 18 years * Diagnosis of radically resected IB-IIIA NSCLC with EGFR activating mutation * Treatment with adjuvant osimertinib (starting from September 2022, date of approval) according to clinical practice * Recurrence of disease during or after adjuvant therapy with osimertinib received according to clinical practice * Availability of tissue and/or liquid biopsy sample collected at the time of recurrence * Signed informed consent. * Exclusion Criteria: * Unavailability of tissue and/or liquid biopsy sample collected at the time of recurrence * Concomitant synchronous malignancies aside from NSCLC or any concurrent and/or active malignancy that has required treatment within 2 years * Involvement in the planning and/or conduct of the study (applies to both investigator staff and/or staff at the study site).
Where it's running
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U.O.C. Oncologia Medica Azienda Unità Sanitaria Locale della Romagna
Ravenna, Ra, Italy Recruiting -
IRCCS Oncologico Giovanni Paolo II
Bari, Ba, Italy Active not recruiting -
Asst Papa Giovanni Xxiii Sc Oncologia
Bergamo, Bg, Italy Not yet recruiting -
UOC di Oncologia Medica IRCCS - Policlinico S. Orsola Malpighi
Bologna, Bo, Italy Not yet recruiting -
Humanitas Istituto Clinico Catanese Contrada Cubba
Misterbianco, CT, Italy Not yet recruiting -
A.S.S.T - Monza Ospedale San Gerardo
Monza, Mb, Italy Not yet recruiting
Show 19 more locations
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Grande Ospedale Metropolitano Niguarda Ca' Granda
Milan, Michigan, Italy Active not recruiting -
Dip Oncologia-Ematologia - UO Oncologia AOU Policlinico di Modena
Modena, Missouri, Italy Active not recruiting -
Irccs Humanitas Research Hospital
Milan, Mi, Italy Not yet recruiting -
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
Milan, Mi, Italy Not yet recruiting -
Ospedale San Raffaele Dipartimento di Oncologia Medica
Milan, Mi, Italy Not yet recruiting -
European Institute of Oncology IRCCS
Milan, Mi, Italy Not yet recruiting -
UOC di Oncologia Medica 2 - IOV Istituto Oncologico Veneto
Padova, Pd, Italy Not yet recruiting -
S.O.C. di Oncologia Medica e dei Tumori Immuno-correlati, Centro di Riferimento Oncologico IRCCS
Aviano, Pn, Italy Not yet recruiting -
UOC di Oncologia Medica Azienda Ospedaliero-Universitaria di Parma
Parma, Pr, Italy Not yet recruiting -
S.C. Oncologia Provinciale, Azienda USL-IRCCS di Reggio Emilia
Reggio Emilia, Re, Italy Active not recruiting -
Fondazione Policlinico Universitario Campus Bio-Medico
Roma, Rm, Italy Not yet recruiting -
Ifo-Istituto Regina Elena - Oncologia Medica 1
Roma, Rm, Italy Not yet recruiting -
Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS
Roma, Rm, Italy Not yet recruiting -
AOU San Luigi Gonzaga - SSD oncologia polmonare
Orbassano, To, Italy Not yet recruiting -
SC Oncologia ASST Sette Laghi "Ospedale di Circolo e Fondazione Macchi "
Varese, VA, Italy Not yet recruiting -
"OSPEDALE P. PEDERZOLI" Casa di Cura Privata S.p.A.
Peschiera del Garda, Vr, Italy Active not recruiting -
AOU Integrata di Verona - Ospedale Borgo Trento
Verona, Vr, Italy Not yet recruiting -
Oncologia Clinica Sperimentale Toraco-Polmonare, IRCCS Pascale di Napoli
Naples, Italy Not yet recruiting -
A.O.U. "Maggiore della Carita'"- S.C.D.U Oncologia
Novara, Italy Not yet recruiting
Study contacts
- Study coordinator: Alessandro Leonetti, MD
- Email: aleonetti@ao.pr.it
- Phone: +39 0521702682
Similar studies
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BL-B01D1 with Osimertinib before/around surgery for EGFR-mutant resectable NSCLC
A Phase II/III trial tests if adding BL-B01D1 to osimertinib around surgery helps people with resectable EGFR-mutant non-small cell lung cancer.
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.