Treatment Patterns and Clinical Outcomes in Unresectable Stage III EGFR-Mutated Non-Small Cell Lung Cancer in China

Following the LAURA study (NCT03521154), the third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) osimertinib was approved for unresectable stage III EGFR-mutated non-small cell lung cancer (NSCLC) after chemoradiotherapy. To inform clinical decision-making, we report real-world (rw) treatment patterns and outcomes in Chinese patients with unresectable stage III EGFR-mutated NSCLC who underwent chemoradiotherapy.

Data were retrospectively extracted from the China Multicentre Lung Cancer Precision Medicine Registry medical records of adults with unresectable stage III EGFR-mutated (exon 19 deletion [Ex19del]/leucine-to-arginine substitution at position 858 [L858R]) NSCLC (diagnosed Jan 2016-Dec 2019) who received standard-of-care chemoradiotherapy. The primary outcome was rw progression-free survival (rwPFS) and secondary outcomes were mutation testing patterns, treatment sequencing post-diagnosis, and rw time-to-next treatment or death (rwTTNTD).

Of 51 patients, 65%/33% had Ex19del/L858R mutations. As first treatment, 31 patients (61%) received chemoradiotherapy plus EGFR-TKI (mainly first-generation) and 20 (39%) chemoradiotherapy alone. Of 34 (67%) patients who received first-subsequent treatment, most were given EGFR-TKI (88%). In patients who received chemoradiotherapy plus EGFR-TKIs (first-generation) or chemoradiotherapy alone, median (95% confidence interval) rwPFS/rwTTNTD was 22.6 (14.2-34.6)/25.0 (21.5-44.7) or 12.2 (10.5-not estimable)/13.6 (10.5-not estimable) months, respectively.

These rw results show that while first-generation EGFR-TKIs are associated with numerically longer rwPFS and rwTTNTD relative to chemoradiotherapy alone in Chinese patients with unresectable stage III EGFR-mutated NSCLC, there remains an unmet need to prolong survival.