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Osimertinib as Second- and ≥Third-Line Treatment in Advanced and Recurrence EGFR-Mutant NSCLC Patients Harboring

Mu-Han Peng1, Yen-Hsiang Huang1,2,3, Kuo-Hsuan Hsu1,2

  • 1Department of Chest Medicine, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung 407, Taiwan.

Cancers
|January 8, 2025
PubMed
Abstract

Insights

Osimertinib shows effectiveness in advanced EGFR-mutant non-small-cell lung cancer (NSCLC) patients with T790M mutations, regardless of whether it

Area of Science:

  • Oncology
  • Medical Research
  • Pharmacology

Background:

  • Osimertinib is a standard sequential therapy for advanced and recurrent Epidermal Growth Factor Receptor (EGFR)-mutant non-small-cell lung cancer (NSCLC) patients with the T790M mutation.
  • Patients typically receive osimertinib after treatment with first- or second-generation EGFR Tyrosine Kinase Inhibitors (TKIs).
  • Resistance to initial TKI therapies necessitates evaluation of subsequent treatment lines.

Purpose of the Study:

  • To compare the clinical outcomes of osimertinib when used as a second-line treatment versus a third-line or later treatment.
  • To assess the efficacy of osimertinib in advanced and recurrent EGFR-mutant NSCLC with T790M mutations across different treatment lines.

Main Methods:

  • Retrospective analysis of 158 advanced and recurrent EGFR T790M-positive NSCLC patients who received osimertinib sequentially.
  • Patients had prior first-line treatment with gefitinib, erlotinib, or afatinib.
  • Outcomes were compared between patients receiving osimertinib as second-line versus third-line or later therapy.

Main Results:

  • 99 patients (62.7%) received osimertinib as second-line, and 59 (37.3%) received it as third-line or later.
  • Median progression-free survival (PFS) was 10.7 months for second-line vs. 8.9 months for ≥3rd-line.
  • Median overall survival (OS) from first-line was 73.2 months for second-line vs. 57.5 months for ≥3rd-line; no statistically significant differences were found.

Conclusions:

  • Osimertinib demonstrates effectiveness and clinical benefit as both second-line and third-line or later treatment in EGFR-mutant NSCLC with T790M mutations.
  • The study supports the continued use of osimertinib in later lines of therapy for patients who develop resistance to earlier EGFR-TKI treatments.
  • Osimertinib offers a valuable therapeutic option for advanced and recurrent NSCLC patients progressing on sequential TKI therapy.
Keywords:
T790Mepidermal growth factor receptornon-small-cell lung cancerosimertinibtyrosine kinase inhibitor

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