Real-World Data Of Osimertinib In Patients With Pretreated Non-Small Cell Lung Cancer: A Retrospective Study

Area of Science:

• Oncology
• Pharmacology

Background:

• Non-small-cell lung cancer (NSCLC) remains a leading cause of cancer-related deaths worldwide.
• Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have revolutionized NSCLC treatment.
• Acquired resistance to first- and second-generation EGFR-TKIs, often mediated by the T790M mutation, presents a significant clinical challenge.

Purpose of the Study:

• To evaluate the real-world efficacy and safety of osimertinib in patients with pretreated advanced NSCLC.
• To assess the treatment outcomes in patients with EGFR T790M resistance mutations after prior EGFR-TKI or chemotherapy treatments.

Main Methods:

• A retrospective analysis was conducted on 94 patients with advanced NSCLC who received osimertinib post-progression on prior therapies.
• Data collected included objective response rate (ORR), disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), and safety profiles.
• Subgroup analyses were performed, including stratification by T790M mutation status and specific EGFR mutations (exon19del, L858R), as well as patients with central nervous system metastases.

Main Results:

• The overall objective response rate (ORR) was 47.3% and the disease control rate (DCR) was 90.1% in evaluable patients (n=91).
• Median progression-free survival (PFS) was 8.6 months in the overall population, with longer PFS observed in patients with detectable T790M mutations (8.6 months) compared to those without (3.2 months).
• Median PFS was significantly longer for T790M-positive patients with exon19del compared to those with L858R (17.9 months vs 7.3 months; P<0.001). Intracranial time to progression was not reached in patients with CNS metastases.

Conclusions:

• Osimertinib demonstrates high activity and a manageable safety profile in pretreated advanced NSCLC patients, particularly those harboring the EGFR T790M mutation.
• The real-world data support the efficacy of osimertinib in a diverse NSCLC patient population, including those with central nervous system involvement.
• Osimertinib represents a valuable therapeutic option for patients who have progressed on prior EGFR-TKI therapies.