2022 World Conference on Lung Cancer (ePosters)-EP08.02-104. Osimertinib in Untreated EGFR-Mutant Non-small Cell Lung Cancers: Overall Survival and Budget Impact Analysis in Real-World

EP08.02-104. Osimertinib in Untreated EGFR-Mutant Non-small Cell Lung Cancers: Overall Survival and Budget Impact Analysis in Real-World

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The observational FLOWER study evaluated the effectiveness and safety of osimertinib as a first-line treatment for untreated EGFR-mutant advanced non-small cell lung cancer (NSCLC) patients. The study, conducted in six Italian centers, included data from 91 out of 126 patients, with a median follow-up of 21.1 months.<br /><br />The updated analysis confirmed the effectiveness of osimertinib in this patient population, although the median overall survival (mOS) had not been reached at the time of the analysis. The budget impact (BI) of osimertinib on the national health system was also assessed. The BI of osimertinib was found to be in line with previous data and the incremental cost-effectiveness ratio (ICER) calculated on time to treatment discontinuation (mTTD) was lower than the Italian willingness-to-pay threshold.<br /><br />The diagnostic-therapeutic pathway at disease progression was also evaluated. Rebiopsy was performed in a significant proportion of patients, with tissue and liquid biopsies being the most common methods used. Molecular alterations identified in the rebiopsied samples included MET amplification, EGFR and MET amplification, HER2 amplification, and others. A small subset of patients experienced histological transformation to large cell neuroendocrine carcinoma.<br /><br />Subsequent treatments were administered after discontinuation of osimertinib. The overall response rate (ORR) and median progression-free survival (mPFS) were evaluated for second-line and third-line therapies.<br /><br />A cost-effectiveness analysis was conducted, comparing osimertinib with erlotinib and gefitinib. The ICER was calculated based on mTTD and cost per patient. The analysis showed that osimertinib had a favorable ICER compared to the other two drugs. Additionally, a BI gap between real-world BI calculated based on mTTD and theoretical BI calculated based on mPFS from the FLAURA study was observed.<br /><br />Overall, this study provides real-world evidence of the effectiveness and safety of osimertinib as a first-line treatment for untreated EGFR-mutant NSCLC patients. The findings suggest that osimertinib is a cost-effective option, and the results of this study have important implications for the management of this patient population.

Asset Subtitle

Martina Lorenzi

Meta Tag

Speaker Martina Lorenzi

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

observational FLOWER study

osimertinib

first-line treatment

EGFR-mutant

NSCLC patients

effectiveness

safety

overall survival

budget impact

cost-effectiveness analysis