Exploratory analysis of immunochemotherapy compared to chemotherapy after EGFR‐TKI in non–small cell lung cancer patients with EGFR mutation: A multicenter retrospective study

Abstract

Background Patients with epidermal growth factor receptor (EGFR)‐mutated, advanced non–small cell lung cancer have received immunochemotherapy as one of the treatment options after tyrosine kinase inhibitor (TKI) failure. Methods We retrospectively examined EGFR‐mutant patients treated with atezolizumab‐bevacizumab‐carboplatin‐paclitaxel (ABCP) therapy or platinum‐based chemotherapy (Chemo) after EGFR‐TKI therapy at five institutions in Japan. Results A total of 57 patients with EGFR mutation were analyzed. The median progression‐free survival (PFS) and overall survival (OS) in the ABCP (n = 20) and Chemo (n = 37) were 5.6 and 20.9 months, 5.4 and 22.1 months, respectively (PFS, p = 0.39; OS, p = 0.61). In programmed death‐ligand 1 (PD‐L1)–positive patients, median PFS in the ABCP group was longer than in the Chemo group (6.9 vs. 4.7 months, p = 0.89). In PD‐L1–negative patients, median PFS in the ABCP group was significantly shorter than in the Chemo group (4.6 vs. 8.7 months, p = 0.04). There was no difference in median PFS between the ABCP and Chemo groups in the subgroups of brain metastases, EGFR mutation status, or chemotherapy regimens, respectively. Conclusion The effect of ABCP therapy and chemotherapy was comparable in EGFR‐mutant patients in a real‐world setting. The indication for immunochemotherapy should be carefully considered, especially in PD‐L1–negative patients.