2023 World Conference on Lung Cancer (Posters)-EP12.01. Metastatic Non-Small Cell Lung Cancer With EGFR Mutations: Treatment Pattern and Outcomes From a Systematic Literature Review

EP12.01. Metastatic Non-Small Cell Lung Cancer With EGFR Mutations: Treatment Pattern and Outcomes From a Systematic Literature Review - PDF(Abstract)

Back to course

Pdf Summary

This study aimed to analyze the current treatment patterns and outcomes in metastatic non-small cell lung cancer (mNSCLC) with EGFR mutations (EGFRm) in order to identify opportunities for future therapeutic development. The review analyzed published studies from 2017-2022 that included adult patients with mNSCLC treated with pharmacotherapy.<br /><br />The analysis included 130 studies out of 13,312 identified records. Third-generation EGFR tyrosine kinase inhibitors (TKIs) showed a median progression-free survival (mPFS) of 18.9-20.8 months in randomized controlled trials (RCTs) and 16.8 months in an observational study of osimertinib, in the first-line setting. The overall survival (OS) for these trials was reported at 38.6 months.<br /><br />In the post-EGFR TKI setting, platinum-based chemotherapy (PBC) regimens had an mPFS of 4.3-5.4 months in RCTs, with an OS benefit of 15.6 months when adjusted for crossover. However, recent studies combining immune checkpoint inhibitors (ICIs) with PBC did not show improvement over PBC alone, with an mPFS of 5.6-6.9 months.<br /><br />In later-line studies, salvage regimens including pemetrexed, gemcitabine, docetaxel, and paclitaxel were used, with an mPFS ranging from 2.7-2.95 months. Common adverse events (AEs) reported with EGFR TKIs were diarrhea, rash, and paronychia, while nausea, decreased appetite, and anemia were common with PBC regimens, and nausea, fatigue, and peripheral neuropathy were common with ICI regimens.<br /><br />Overall, the study found that treatment options after a third-generation EGFR TKI remain limited, with minimal PFS and OS benefits. PBC- and ICI-based regimens showed only a modest PFS benefit of 5 months. Salvage regimens had even shorter PFS, below 3 months. These poor outcomes and the lack of current trials in this setting highlight the need for new therapeutic options in EGFR-mutated NSCLC.

Asset Subtitle

Shirish Gadgeel

Meta Tag

Speaker Shirish Gadgeel

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

metastatic non-small cell lung cancer

EGFR mutations

treatment patterns

outcomes

therapeutic development

EGFR tyrosine kinase inhibitors

progression-free survival

overall survival

platinum-based chemotherapy

immune checkpoint inhibitors