T790M detection rate after first-line combination therapy with bevacizumab and EGFR-TKIs in advanced NSCLC (TERRA...

Area of Science:

• Oncology
• Molecular Biology
• Pharmacology

Background:

• Limited real-world data exists on T790M mutation rates after resistance to first-line epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) plus bevacizumab in advanced non-small-cell lung cancer (NSCLC).
• Understanding T790M mutation predictors is crucial for guiding subsequent treatment strategies in NSCLC patients.

Purpose of the Study:

• To analyze predictors of acquired T790M mutations in advanced NSCLC patients receiving first-line EGFR-TKIs and bevacizumab.
• To evaluate the T790M mutation rate in this specific patient population.

Main Methods:

• A multicenter retrospective study involving 107 advanced NSCLC patients from 11 Taiwanese tertiary referral centers.
• Analysis of survival data and genomic test results after disease progression on first-line EGFR-TKIs and bevacizumab therapy.
• Specific focus on patients treated with afatinib (a second-generation EGFR-TKI) plus bevacizumab.

Main Results:

• The combination of afatinib and bevacizumab demonstrated improved progression-free survival (PFS).
• Of the patients analyzed after disease progression, 55.1% (59/107) tested positive for the EGFR T790M mutation.
• A longer duration of first-line therapy was identified as a potential predictor for subsequent T790M mutations.

Conclusions:

• This study provides early insights into the T790M mutation rate following first-line EGFR-TKI and bevacizumab combination therapy in advanced NSCLC.
• The observed longer PFS with bevacizumab addition warrants further investigation into its potential impact on subsequent T790M mutation development.