Real-World Outcomes and Subsequent Treatment Patterns in Patients with Advanced Non-Small Cell Lung Cancer and...

Area of Science:

• Oncology
• Medical Genetics
• Pharmacology

Background:

• Osimertinib is a recommended first-line treatment for advanced non-small cell lung cancer (NSCLC) with atypical EGFR mutations.
• Real-world data for this specific patient population are limited.
• This study addresses the need for real-world evidence in routine US practice.

Purpose of the Study:

• To evaluate the real-world outcomes of first-line osimertinib treatment in advanced NSCLC patients with atypical EGFR mutations.
• To analyze subsequent treatment patterns in this patient group.
• To compare outcomes between different subgroups of atypical EGFR mutations.

Main Methods:

• Retrospective analysis of medical records from an oncology database.
• Inclusion criteria: adults with stage IIIB-IV NSCLC, atypical EGFR mutations, treated with first-line osimertinib (April 2018-March 2020).
• Patients were categorized into two groups: compound EGFR mutations (including classical and atypical) or de novo T790M only (Group A), and atypical EGFR mutations only (Group B).

Main Results:

• 55 patients were analyzed; median follow-up was 11 months.
• Median real-world progression-free survival (rwPFS) was 8.8 months and median overall survival (OS) was 28.5 months.
• Patients with compound EGFR mutations (Group A) showed longer median rwPFS (20.3 months) and OS (42.5 months) compared to those with atypical mutations only (Group B).

Conclusions:

• First-line osimertinib demonstrates real-world clinical benefits for advanced NSCLC patients with atypical EGFR mutations.
• The study suggests a potentially greater benefit for patients with compound EGFR mutations.
• Real-world data support the use of osimertinib in this challenging patient subgroup.