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Osimertinib Efficacy in EGFR+ NSCLC

January, 01, 2024 | Lung Cancer, NSCLC (Non-Small Cell Lung Cancer)

KEY TAKEAWAYS

  • The FLAURA phase III trial aimed to assess the long-term survival and treatment patterns after first-line osimertinib in advanced EGFR-mutant NSCLC patients.
  • The primary endpoints were OS and TTNTD.
  • The results demonstrated comparable median OS and rwPFS, reinforcing the effectiveness of first-line osimertinib in all EGFR-mutated NSCLC patients.

As the preferred first-line treatment for advanced EGFR-mutated non-small cell lung cancer NSCLC, osimertinib is a third-generation, irreversible EGFR-tyrosine kinase inhibitor with activity in the central nervous system, selectively targeting EGFR-TKI sensitizing and T790M resistance mutations. Daichi Fujimoto and others aimed to present the outcomes of patients with advanced EGFR-mutated NSCLC in a Japanese cohort following first-line osimertinib treatment, including an analysis of their second-line treatment patterns.

The study utilized the CyberOncology® data platform, operated by PRiME-R®, to identify data for adult patients with EGFR-mutated advanced NSCLC who initiated first-line osimertinib in Japan between August 21, 2018, and December 31, 2020. 

Primary endpoints included overall survival (OS), second-line treatment patterns, and time to the next treatment or death (TTNTD). Secondary endpoints covered baseline patient characteristics and time to treatment discontinuation (TTD). Exploratory endpoints included OS by EGFR mutation type and real-world progression-free survival (rwPFS). Additionally, OS, TTNTD, TTD, and rwPFS were assessed in a cohort aligning with the FLAURA trial (NCT02296125) inclusion criteria (FLAURA-like cohort).

Of about 143 patients, the median age was 70 years (IQR: 64–75), 69% were female, 96% had exon 19 deletion or L858R mutations, 60% were never smokers, and 80% had an Eastern Cooperative Oncology Group performance status score of 0/1. At the data cutoff (December 31, 2022), median follow-up was 32.3 months (IQR: 24.8–39.4), and time-to-event outcomes were comparable between all patients and the FLAURA-like cohort. Of the 50 (35%) patients who received subsequent treatment, 54% received EGFR-TKIs, 32% received chemotherapy, 12% received immunotherapy and chemotherapy, and 2% received other treatments. 

The study demonstrated that median OS and rwPFS in all patients align with outcomes observed in the FLAURA trial. These findings strongly support the efficacy of first-line osimertinib in a real-world setting. Research was sponsored by AstraZeneca.

Source: https://cslide.ctimeetingtech.com/asia2023/attendee/confcal/show/session/78 

Clinical Trial: https://clinicaltrials.gov/study/NCT02296125 

Fujimoto D, Takiguchi Y, Matsumoto S, et al. (2023) ‘’Long-term survival and treatment (tx) patterns after first-line (1L) osimertinib in patients (pts) with epidermal growth factor receptor (EGFR) mutation-positive (m) advanced non-small cell lung cancer (NSCLC): Japanese cohort of a global real-world (rw) observational study.’’ Presented at ESMO ASIA 2023 (499P).

 

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