Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer

Auliac, J.B.; Saboundji, K.; Meynier, André; Madelaine, J.; Quéré, Gilles; Masson, Philippe; Vergnenègre, A.; Raymond, Stéphane; Chiappa, A.M.; Hauss, Pierre-Alexandre; Fournel, P.; Corre, Romain; Chouaïd, C.

doi:10.1007/s11523-019-00646-4

Cited by 7 publications

(15 citation statements)

References 26 publications

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“…Consistent with our findings, a similar mPFS and mOS was reported for patients receiving osimertinib as a second, third or further line of treatment in the AURA extension and AURA2 pooled analysis [42]. Three real-world studies reported no statistically significant difference between outcomes for osimertinib administered as a second or as a further line of treatment [29,34,35]. On the basis of these observations, it is tempting to suggest a role of tissue rebiopsy or repeated liquid biopsy in T790Mpatients at every disease progression event in order to detect T790M mutation.…”

Section: Discussionsupporting

confidence: 88%

“…In real-world studies, a variable rate of patients received a subsequent treatment after osimertinib failure [29,[34][35][36][37]. The study by Auliac et al included only patients aged >80 years and this could explain the lower proportion of patients receiving subsequent therapies after osimertinib [35], whereas the higher rate reported by Le et al may be explained by selection bias [40]. As in our experience, after osimertinib, most patients received chemotherapy [34][35][36], according to guidelines [21].…”

Section: Discussionmentioning

confidence: 75%

“…The study by Auliac et al included only patients aged >80 years and this could explain the lower proportion of patients receiving subsequent therapies after osimertinib [35], whereas the higher rate reported by Le et al may be explained by selection bias [40]. As in our experience, after osimertinib, most patients received chemotherapy [34][35][36], according to guidelines [21]. One study reported immune checkpoint inhibitors as the most frequent therapy after osimertinib, but included patients from 2011 [40].…”

Section: Discussionmentioning

confidence: 88%

“…Other real-world studies have recently reported outcomes and response rates in line with pivotal trials, even though the added value of our study is the inclusion of a T790Mgroup [28][29][30][31][32][34][35][36][38][39][40][41]43]. In real-world studies, a variable rate of patients received a subsequent treatment after osimertinib failure [29,[34][35][36][37]. The study by Auliac et al included only patients aged >80 years and this could explain the lower proportion of patients receiving subsequent therapies after osimertinib [35], whereas the higher rate reported by Le et al may be explained by selection bias [40].…”

Section: Discussionmentioning

confidence: 97%

“…Previous analysis of the pattern of recurrence with early-generation TKIs reported a more aggressive tumor behavior in T790M + patients, characterized by more new sites of disease compared with negative cases [27]. Several studies investigated the efficacy and safety of osimertinib in the real world in T790M+ patients among Asian [28][29][30][31][32][33], Caucasian [34][35][36][37][38] and both populations [39][40][41]. However, few data about progression patterns with osimertinib are available in T790M + patients, and previous studies did not include a T790Mcontrol group [30,33,34,36,37].…”

mentioning

confidence: 99%

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Real-World Data on Treatment Outcomes in EGFR -Mutant Non-Small-Cell Lung Cancer Patients Receiving Osimertinib in Second or Further Lines

et al. 2021

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Aims: This study describes real-world outcomes of pretreated EGFR T790M-positive (T790M+) advanced non-small-cell lung cancer patients progressing after first- or second-generation tyrosine kinase inhibitors and receiving osimertinib, compared with T790M-negative (T790M-) patients. We have also described progression patterns and treatment sequences. Patients & methods: This is a retrospective multicenter Italian observational study including consecutive Caucasian patients referred between 2014 and 2018. Results: 167 patients were included. Median progression-free survival was 9.8 months (95% CI: 8.3–13.3) for T790M+ and 6.0 months (95% CI: 4.9–7.2) for T790M- patients, respectively. Median overall survival was 20.7 months (95% CI: 18.9–28.4) for T790M+ and 10.6 months (95% CI: 8.6–23.6) for T790M- patients, respectively. The T790M mutation correlated with absence of new sites of disease. After progression, most T790M+ patients continued osimertinib, whereas most T790M- patients received a different treatment line. Conclusion: Better outcomes were shown in patients receiving osimertinib. A more limited progression pattern for T790M+ was suggested.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

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Real-World Data on Treatment Outcomes in EGFR -Mutant Non-Small-Cell Lung Cancer Patients Receiving Osimertinib in Second or Further Lines

et al. 2021

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Exploring the impact of patient‐specific clinical features on osimertinib effectiveness in a real‐world cohort of patients with EGFR mutated non‐small cell lung cancer

van Veelen,

Veerman,

Verschueren

et al. 2023

Intl Journal of Cancer

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Osimertinib is prescribed to patients with metastatic non‐small cell lung cancer (NSCLC) and a sensitizing EGFR mutation. Limited data exists on the impact of patient characteristics or osimertinib exposure on effectiveness outcomes. This was a Dutch, multicenter cohort study. Eligible patients were ≥18 years, with metastatic EGFRm+ NSCLC, receiving osimertinib. Primary endpoint was progression‐free survival (PFS). Secondary endpoints included overall survival (OS) and safety. Kaplan‐Meier analyses and multivariate Cox proportional hazard models were performed. In total, 294 patients were included. Primary EGFR‐mutations were mainly exon 19 deletions (54%) and p.L858R point mutations (30%). Osimertinib was given in first‐line (40%), second‐line (46%) or beyond (14%), with median PFS 14.4 (95% CI: 9.4‐19.3), 13.9 (95% CI: 11.3‐16.1) and 8.7 months (95% CI: 4.6‐12.7), respectively. Patients with low BMI (<20.0 kg/m2) had significantly shorter PFS/OS compared to all other subgroups. Patients with a high plasma trough concentration in steady state (Cmin,SS; >271 ng/mL) had shorter PFS compared to a low Cmin,SS (<163 ng/mL; aHR 2.29; 95% CI: 1.13‐4.63). A significant longer PFS was seen in females (aHR = 0.61, 95% CI: 0.45‐0.82) and patients with the exon 19 deletion (aHR = 0.58, 95% CI: 0.36‐0.92). A trend towards longer PFS was seen for TP53 wild‐type patients, while age did not impact PFS. Patients with a primary EGFR exon 19 deletion had longer PFS, while a low BMI, male sex and a high Cmin,SS were indicative for shorter PFS and/or OS. Age was not associated with effectiveness outcomes of osimertinib.

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Expert consensus to optimize the management of older adult patients with advanced EGFR-mutated non-small cell lung cancer

Nadal,

Oré-Arce,

Remon

et al. 2023

Clin Transl Oncol

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Lung cancer (LC) is associated with ageing, with the average age of affected individuals being approximately 70 years. However, despite a higher incidence and prevalence among older people, the older adult population is underrepresented in clinical trials. For LC with Epidermal Growth Factor Receptor (EGFR) mutations, there is no clear association of this mutation with age. Geriatric assessments (GAs) and a multidisciplinary approach are essential for defining the optimal treatment. In this consensus, a group of experts selected from the Oncogeriatrics Section of the Spanish Society of Medical Oncology (Sección de Oncogeriatría de la Sociedad Española de Oncología Médica—SEOM), the Spanish Lung Cancer Group (Grupo Español de Cáncer de Pulmón—GECP) and the Association for Research on Lung Cancer in Women (Asociación para la Investigación del Cáncer de Pulmón en Mujeres—ICAPEM) evaluate the scientific evidence currently available and propose a series of recommendations to optimize the management of older adult patients with advanced LC with EGFR mutations.

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Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer

Cited by 7 publications

References 26 publications

Real-World Data on Treatment Outcomes in EGFR -Mutant Non-Small-Cell Lung Cancer Patients Receiving Osimertinib in Second or Further Lines

Real-World Data on Treatment Outcomes in EGFR -Mutant Non-Small-Cell Lung Cancer Patients Receiving Osimertinib in Second or Further Lines

Exploring the impact of patient‐specific clinical features on osimertinib effectiveness in a real‐world cohort of patients with EGFR mutated non‐small cell lung cancer

Expert consensus to optimize the management of older adult patients with advanced EGFR-mutated non-small cell lung cancer

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