Combining Osimertinib With Chemotherapy in EGFR-Mutant NSCLC at Progression

Area of Science:

• Oncology
• Pharmacology
• Medical Research

Background:

• Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, has shown efficacy in non-small cell lung cancer (NSCLC) with EGFR mutations.
• Limited data exists on the combination of osimertinib with chemotherapy in advanced NSCLC.
• Understanding the efficacy and safety of this combination is crucial for treatment optimization.

Purpose of the Study:

• To evaluate the efficacy and safety of combining osimertinib with chemotherapy in advanced EGFR-mutated NSCLC.
• To assess outcomes including duration on treatment (DOT), overall survival (OS), and central nervous system (CNS) control.
• To analyze safety profiles of concurrent osimertinib and chemotherapy regimens.

Main Methods:

• Retrospective study at three institutions involving patients with advanced EGFR-mutated NSCLC.
• Inclusion criteria: concurrent osimertinib and chemotherapy in the third-line or beyond.
• Data collection via chart review, assessing efficacy (DOT, OS, CNS outcomes) and safety.

Main Results:

• 44 patients met inclusion criteria; 28 received osimertinib plus platinum doublet, 29 received osimertinib plus single-agent chemotherapy.
• Median DOT was 6.1 months with platinum doublet and 2.6 months with single-agent chemotherapy.
• Median OS was 10.4 months; 84% had CNS metastases at baseline, with 24% experiencing CNS progression.

Conclusions:

• Combination of osimertinib plus chemotherapy appears safe in advanced NSCLC patients with prior treatment progression.
• Favorable CNS disease control was observed in this cohort.
• DOT and survival outcomes were comparable to historical chemotherapy controls.