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(Slides)

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This retrospective study aimed to identify factors predicting rapid progression (RP) in patients with advanced non-small cell lung cancer (NSCLC) receiving first-line osimertinib treatment. The study analyzed the clinical and molecular characteristics of patients with RP and examined the relationship between TP53 mutation and progression-free survival (PFS) and overall survival (OS).<br /><br />The study reviewed records of patients treated with first-line osimertinib at Mount Sinai Hospital from 2015 to 2022. Next-generation sequencing of tumor tissue and/or circulating tumor DNA was performed before osimertinib treatment. Patients were classified as having RP if they experienced radiographic or clinical progression within 100 days of osimertinib initiation.<br /><br />The results showed that poor outcomes in patients with co-mutation of EGFR and TP53 were primarily observed in the Ex21mt-TP53mt co-mutated population. This suggests that the previously observed inferior response of TP53mt cancers to first- and second-generation EGFR tyrosine kinase inhibitors may also extend to osimertinib use in the first-line setting. This difference was more pronounced in Ex21mt-TP53mt NSCLC.<br /><br />Table 1 provided a summary of patient characteristics stratified by rapid progression, while Table 2 provided a summary of patient clinical variables stratified by exon type. Kaplan-Meier plots in Figures A-C showed the median overall survival and progression-free survival in different patient subgroups based on exon type and TP53 mutation status.<br /><br />In conclusion, this study highlighted the importance of TP53 mutation as a predictor of poor outcomes in patients receiving first-line osimertinib for advanced EGFR mutated NSCLC. The findings suggest that patients with Ex21mt-TP53mt NSCLC may have an even lower response to osimertinib compared to other subgroups. Further research is needed to better understand the underlying mechanisms and potential implications for treatment decisions in this patient population.

Asset Subtitle

Fiona Desland

Meta Tag

Speaker Fiona Desland

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

retrospective study

rapid progression

non-small cell lung cancer

NSCLC

osimertinib treatment

TP53 mutation

progression-free survival

overall survival

EGFR mutation

exon type