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Osimertinib or EGFR-TKIs/chemotherapy in patients with EGFR-mutated advanced nonsmall cell lung cancer: A

Lei Huang1, Hao Huang1, Xiao-Ping Zhou2

  • 1Department of Clinical Laboratory, The Affiliated Tumor Hospital of Guangxi Medical University.

Medicine
|October 26, 2019
PubMed
Abstract

Insights

Osimertinib significantly improves outcomes for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. This targeted therapy offers better progression-free survival, overall survival, and response rates, with fewer severe adverse events, particularly for T790M mutation-positive cases.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced non-small cell lung cancer (NSCLC) poses significant treatment challenges.
  • Epidermal growth factor receptor (EGFR) mutations are key drivers in a subset of NSCLC.
  • Targeted therapies like Osimertinib aim to improve efficacy in EGFR-mutated NSCLC.

Purpose of the Study:

  • To conduct a meta-analysis evaluating Osimertinib's impact on treatment efficacy in advanced NSCLC.
  • To compare Osimertinib with existing epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) or chemotherapy.
  • To analyze key efficacy endpoints and safety profiles.

Main Methods:

  • Systematic review and meta-analysis of 6 eligible clinical trials.
  • Inclusion criteria: NSCLC patients with EGFR mutations comparing Osimertinib to EGFR-TKIs/chemotherapy.
  • Pooled analysis of progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR), and adverse events (AEs).

Main Results:

  • Osimertinib demonstrated significant improvements in PFS (HR=0.38) and OS (HR=0.66) compared to control groups.
  • Higher ORR (OR=1.76) and DCR (OR=1.18) were observed with Osimertinib.
  • Reduced incidence of grade 3 or greater AEs (RR=0.50) was noted, particularly in T790M mutation-positive patients.
  • Subgroup analyses indicated potential predictive value of race, sex, age, EGFR mutation type, and smoking history, though not statistically significant across all strata.

Conclusions:

  • Osimertinib offers superior treatment benefits over traditional EGFR-TKIs/chemotherapy for NSCLC patients with EGFR mutations.
  • The efficacy advantage is particularly pronounced in patients with the T790M mutation.
  • Osimertinib represents a valuable therapeutic option, improving survival and response rates while enhancing safety in this patient population.

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