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Clinical Characteristics of Osimertinib Responder in Non-Small Cell Lung Cancer Patients with EGFR-T790M Mutation

Akihiro Yoshimura1, Tadaaki Yamada2, Naoko Okura3

  • 1Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan. aki-y@koto.kpu-m.ac.jp.

Cancers
|March 17, 2019
PubMed

Insights

Progression-free survival (PFS) after initial EGFR-tyrosine kinase inhibitor (TKI) treatment and response to osimertinib may predict treatment effectiveness in non-small cell lung cancer (NSCLC) patients with EGFR mutations. These factors correlate with longer PFS and overall survival (OS) during osimertinib therapy.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Osimertinib is an effective EGFR inhibitor for non-small cell lung cancer (NSCLC) with the EGFR-T790M mutation, often developing resistance to prior EGFR-tyrosine kinase inhibitors (EGFR-TKIs).
  • Predictors for osimertinib treatment response in these patients remain unclear.

Purpose of the Study:

  • To identify factors influencing treatment outcomes in NSCLC patients with the EGFR-T790M mutation receiving osimertinib.
  • To evaluate the correlation between prior EGFR-TKI treatment and subsequent osimertinib efficacy.

Main Methods:

  • Retrospective analysis of 27 NSCLC patients with the EGFR-T790M mutation across five Japanese institutions.
  • Statistical analysis of progression-free survival (PFS) with initial EGFR-TKIs, PFS with osimertinib, overall survival (OS), and osimertinib response rates.

Main Results:

  • Initial EGFR-TKI PFS positively correlated with PFS following osimertinib treatment (p = 0.021).
  • Patients responding to osimertinib showed significantly longer median PFS (17.7 vs. 3.5 months, p = 0.009) and OS (24.2 vs. 13.5 months, p = 0.021) compared to non-responders.
  • Multivariate analysis confirmed initial EGFR-TKI PFS (p = 0.035) and osimertinib response (p = 0.016 for PFS, p = 0.006 for OS) as significant predictors.

Conclusions:

  • Progression-free survival (PFS) after initial EGFR-tyrosine kinase inhibitor (EGFR-TKI) therapy is a significant predictor of outcomes with subsequent osimertinib treatment.
  • Osimertinib response rate is strongly associated with improved PFS and overall survival (OS) in EGFR-T790M mutated NSCLC.
  • These findings suggest that initial EGFR-TKI PFS and osimertinib response may serve as valuable predictive markers for osimertinib efficacy in NSCLC.
Keywords:
EGFR-T790M mutationbiomarkernon-small cell lung cancerosimertinibretrospective study

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