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Osimertinib in Patients with T790M-Positive Advanced Non-small Cell Lung Cancer: Korean Subgroup Analysis from Phase
Myung-Ju Ahn1, Ji-Youn Han2, Dong-Wan Kim3
1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Purpose:
Osimertinib is a third-generation, irreversible, oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that potently and selectively inhibits both EGFR sensitizing mutation and EGFR T790M and has demonstrated efficacy in non-small cell lung cancer (NSCLC) central nervous system (CNS) metastases. We present results of a subgroup analysis of Korean patients from the pooled data of two global phase II trials: AURA extension (NCT01802632) and AURA2 (NCT02094261).
Materials And Methods:
Enrolled patients had EGFR T790M-positive NSCLC and disease progression during or after EGFR-TKI therapy. Patients received osimertinib 80 mg orally once daily until disease progression. The primary endpoint was objective response rate (ORR).
Results:
In total, 66 Korean patients received osimertinib treatment with a median treatment duration of 19 months. In the evaluable-for-response population (n=62), ORR was 74% (95% confidence interval [CI], 61.5 to 84.5) and median duration of response was 9.8 months (95% CI, 7.1 to 16.8). In the full analysis set (n=66), median progression-free survival was 10.9 months (95% CI, 8.3 to 15.0; data cutoff November 1, 2016), and median overall survival was 29.2 months (95% CI, 24.8 to 35.7; data cutoff May 1, 2018). Eight patients with CNS metastases were evaluable for response, none of whom showed CNS progression. The most common adverse events were rash (53%), cough (33%), paronychia, diarrhea, and decreased appetite (each 32%).
Conclusion:
Efficacy and safety profiles of osimertinib in this subgroup are consistent with the global phase II pooled population, which supports osimertinib as a recommended treatment for Korean patients with T790M positive NSCLC.
Insights
Osimertinib effectively treated Korean patients with EGFR T790M-positive non-small cell lung cancer (NSCLC), showing significant response rates and survival benefits. The drug
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Non-small cell lung cancer (NSCLC) remains a leading cause of cancer death globally.
- Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have revolutionized NSCLC treatment.
- The T790M mutation confers resistance to earlier-generation EGFR TKIs, necessitating new therapeutic strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of osimertinib in Korean patients with EGFR T790M-positive NSCLC.
- To present subgroup analysis data from the pooled AURA extension and AURA2 global phase II trials.
- To assess treatment outcomes, including objective response rate (ORR) and survival, in this specific patient population.
Main Methods:
- A subgroup analysis of Korean patients from two global phase II trials (AURA extension and AURA2).
- Patients with EGFR T790M-positive NSCLC and prior EGFR-TKI progression received osimertinib 80 mg daily.
- Primary endpoint was objective response rate (ORR); survival and safety were also assessed.
Main Results:
- 66 Korean patients received osimertinib, with a median treatment duration of 19 months.
- The objective response rate (ORR) was 74% in evaluable patients (n=62).
- Median progression-free survival was 10.9 months and median overall survival was 29.2 months. CNS metastases showed no progression in evaluable patients.
Conclusions:
- Osimertinib demonstrated significant efficacy and a favorable safety profile in Korean patients with T790M-positive NSCLC.
- Treatment outcomes in this subgroup align with the global phase II pooled population.
- These findings support osimertinib as a recommended treatment option for Korean patients with T790M-positive NSCLC.
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