Background: Rates of disease recurrence and death following surgery remain high in early-stage non-small-cell lung cancer (NSCLC), despite adjuvant treatment and curative intent. Recently, osimertinib showed overwhelming evidence for disease-free survival (DFS), as demonstrated by an overall reduction in the risk of disease recurrence or death in the adjuvant setting of 80% versus control in the ADAURA study (stage IB-IIIA; hazard ratio 0.20; 99.12% confidence interval 0.14-0.30; P < 0.001). However, due to the early unblinding of ADAURA and lack of mature overall survival data, there is a need to qualitatively confirm consensus on the clinical and patient relevance of DFS., Materials and Methods: We conducted a modified Delphi panel study consisting of two rounds of surveys, followed by a consensus meeting. An international panel of experts in the field of NSCLC and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) (n = 13) was asked to rate agreement and comment on a list of pre-defined statements covering key consensus gaps. Statements were eliminated or updated between surveys, depending on the level of agreement. A final list of agreed-upon statements was drafted in the consensus meeting., Results: Consensus was reached on 32 qualitative statements, with topics including unmet needs in early-stage NSCLC, the value of DFS, and the value of osimertinib. Crucially, DFS was agreed to be a clinically and patient-relevant endpoint in adjuvant NSCLC. The relevance of DFS was found to relate to the ability of an adjuvant therapy, such as osimertinib, to keep patients in the clinically valuable curative intent setting, while preventing the burden associated with distant and locoregional recurrence, and progressive disease., Conclusions: Addressing the need for measures that reflect clinical benefit is essential to continue improving outcomes for NSCLC patients. To that end, this work provides a qualitative framework for clinicians to consider the clinical and patient relevance of DFS in adjuvant NSCLC and the benefit demonstrated in ADAURA thus far., Competing Interests: Disclosure MP reports being an advisor to Takeda, Pfizer, Roche, Novartis, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Merck Sharp & Dohme, Eli Lilly, Amgen, Sanofi, Gritstone, GlaxoSmithKline; speaker fees from Takeda, Pfizer, Roche, Chugai, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Merck Sharp & Dohme, Illumina; institutional research grants from Takeda, AstraZeneca, Roche, Boehringer Ingelheim. BMS reports being a consultant to Pfizer, AstraZeneca, Galvanize Therapeutics, Flame Therapeutics; advisory boards for AstraZeneca, Pfizer, Genentech, Bristol Myers Squibb; research support to Bristol Myers Squibb; board of Lung Cancer Research Foundation; employment at Xalud Therapeutics, PPD, Pfizer. CG reports receiving honoraria, speaker’s bureau and advisory board fees from AstraZeneca, Boehringer-Ingelheim, and MSD; received travel and accommodation fees from Boehringer-Ingelheim. RC reports honoraria and consultancy fees from AstraZeneca, Boeringher Ingelheim, Lilly Oncology, Roche, Pfizer, MSD, Bristol Myers Squibb, Janssen, Takeda, Bayer, Sanofi, and Novartis; grants paid to institution for conduct of clinical trials or contracted research by Roche, AstraZeneca, Pfizer, Clovis, Lilly Oncology, MSD, BMS, Abbvie, Takeda, Janssen, and Novartis. FdM reports advisor fees from AstraZeneca, Roche, BMS, Novartis, MSD, XCovery, Takeda, Eli Lilly. RAS reports participation in advisory boards for Amgen, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Lily, Merck, Novartis, Pfizer, Roche, Taiho, Takeda, Yuhan; research grant from AstraZeneca, Boehringer Ingelheim. MT reports honoraria and lecture fees from Johnson & Johnson Japan, AstraZeneca KK, Eli Lilly Japan, Chugai Pharmaceutical CO., LTD, Taiho Pharma, Medtronic Japan, Ono Pharmaceutical CO.,LTD, MSD, Bristol-Myers Squibb KK, Teijin Pharma; consulting or advisory roles for AstraZeneca KK, Chugai Pharmaceutical CO Ltd, MSD, Novartis; receiving facilities research grant and commissioned research for Boehringer-Ingelheim Japan, MSD, AstraZeneca KK, Ono Pharmaceutical CO Ltd, MSD, Bristol-Myers Squibb KK, Eli Lilly Japan. SL reports receiving research support from AstraZeneca, Hutchison, BMS, Heng Rui Beigene and Roche, Hansoh; receiving speaker fees from AstraZeneca, Roche, Hansoh, Hengrui Therapeutics; advisor/consultant for Astra Zeneca, Pfizer, Hutchison MediPharma, ZaiLab, GenomiCare, Yuhan Corporation, Menarini, InventisBio Co. Ltd., and Roche. GL reports honoraria and advisory board membership/chair from AstraZeneca, Novartis, Hoffman La Roche, Pfizer, Abbvie, Merck, Bristol Myers Squibb, and Takeda; industry research funding from Takeda, AstraZeneca, and Boehringer Ingelheim; educational sessions for AstraZeneca, Takeda, EMD-Serono, Pfizer. RGC reports participating in advisory boards for MSD, Bristol-Myers, Roche, Boehringer Ingelheim, Pfizer, Novartis, AstraZeneca, Lilly, Takeda; consulting for MSD, Bristol-Myers, Roche, Boehringer Ingelheim, Pfizer, Novartis, AstraZeneca, Lilly, Takeda; receiving speaker honoraria from MSD, Bristol-Myers, Roche, Boehringer Ingelheim, Pfizer, Novartis, AstraZeneca, Lilly, Takeda. MT reports speaker and consultancy fees from AstraZeneca, Pfizer, Eli-Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Otsuka, Takeda, Pierre Fabre, Amgen, Merck; received institutional research grants from AstraZeneca, Boehringer Ingelheim. All other authors have declared no conflicts of interest, (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)