2023 World Conference on Lung Cancer (Posters)-EP12.01. Predictors of Poor Outcomes Among Patients Receiving 1st-Line Osimertinib for Advanced EGFR Mutated Non-Small Cell Lung Cancer

EP12.01. Predictors of Poor Outcomes Among Patients Receiving 1st-Line Osimertinib for Advanced EGFR Mutated Non-Small Cell Lung Cancer - PDF(Abstract)

Back to course

Pdf Summary

This study examined the predictors of poor outcomes in patients with metastatic non-small cell lung cancer (NSCLC) who received first-line treatment with osimertinib, a targeted therapy for EGFR mutated NSCLC. Real-world studies have shown that a significant portion of patients do not respond to osimertinib. Co-mutation of EGFR and TP53 has been known to negatively impact outcomes in patients treated with EGFR tyrosine kinase inhibitors (TKIs), but little is known about the factors that predict rapid progression on osimertinib in the first-line setting. <br /><br />The study reviewed the records of 101 patients with advanced NSCLC who were treated with first-line osimertinib at Mount Sinai Hospital. It was found that 12 patients (11.9%) experienced rapid progression. The cohort had mutations in 47 distinct genes and 9 amplifications. TP53 mutation (mt) was found in 58 (57.4%) patients, but it was not significantly associated with rapid progression. However, a significant decrease in median progression-free survival (mPFS) and median overall survival (mOS) was observed in patients with Ex21mt-TP53mt co-mutation compared to patients with Ex21mt-TP53wildtype (wt) disease.<br /><br />The study concluded that poor outcomes in patients with EGFR and TP53 co-mutation were primarily driven by the Ex21mt-TP53mt co-mutated population. This suggests that the inferior disease response of TP53mt cancers to first- and second-generation EGFR TKIs may also extend to osimertinib use in the first-line setting, particularly in patients with Ex21mt-TP53mt NSCLC. <br /><br />Overall, this study provides insights into the predictors of poor outcomes in patients with metastatic NSCLC receiving first-line osimertinib treatment, emphasizing the importance of considering TP53 mutation status in treatment decision-making.

Asset Subtitle

Fiona Desland

Meta Tag

Speaker Fiona Desland

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

predictors

poor outcomes

metastatic non-small cell lung cancer

osimertinib

co-mutation

rapid progression

TP53 mutation

median progression-free survival

median overall survival

treatment decision-making