Treatment Patterns and Resource Use After Osimertinib Discontinuation in Patients with EGFR + Metastatic NSCLC

Area of Science:

• Oncology
• Pharmacology
• Clinical Research

Background:

• Current guidelines recommend EGFR tyrosine kinase inhibitors (TKIs), particularly osimertinib, for first-line treatment of EGFR-mutated metastatic non-small cell lung cancer (mNSCLC).
• Acquired resistance to targeted therapies like osimertinib is common, necessitating subsequent treatment lines.
• Systemic chemotherapy is typically recommended after progression on targeted therapy.

Purpose of the Study:

• To characterize the subsequent line of therapy (LOT) following osimertinib discontinuation in patients with EGFR-mutated mNSCLC.
• To evaluate treatment patterns and duration of subsequent therapies.
• To identify unmet needs in managing EGFR TKI resistance.

Main Methods:

• Retrospective analysis of medical and pharmacy claims data.
• Inclusion of adult patients who initiated a subsequent LOT after discontinuing osimertinib between November 2015 and September 2019.
• Characterization of treatment regimens, duration, and healthcare utilization.

Main Results:

• 135 patients met the inclusion criteria.
• Most patients (57%) received platinum-based chemotherapy in the subsequent LOT, with 40.3% including immuno-oncology therapy.
• EGFR TKI reuse or continuation was observed in 24% of patients.
• The median time to treatment discontinuation for the subsequent LOT was short (2.4 months).
• Significant proportions of patients experienced inpatient (31.9%) or emergency department (35.6%) visits.

Conclusions:

• The subsequent line of therapy following osimertinib in EGFR-mNSCLC is often of short duration.
• Tolerability issues appear to be a significant factor contributing to treatment discontinuation.
• There is a high unmet need for novel therapeutic strategies to overcome EGFR TKI resistance.