2023 World Conference on Lung Cancer (Posters)-EP12.01. Updated First-line Osimertinib in Asian patients with Advanced EGFR-mutated Lung Cancer

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Researchers from the National Cancer Centre Singapore have conducted a study to evaluate the use of osimertinib as a first-line treatment for Asian patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). The study included 161 consecutive patients who were treated with osimertinib between June 2016 and July 2020. The researchers analyzed patient characteristics, concomitant mutations, baseline brain metastases, time-to-treatment failure, and survival outcomes.<br /><br />The results showed that the majority of patients were female (65.8%) and never-smokers (80.7%). The most common EGFR mutation subtypes were exon 19 deletion (55.9%) and exon 21 mutations (36.6%). Baseline brain metastases were present in 52.2% of patients, with 34.5% receiving radiotherapy to the brain before starting osimertinib. The overall response rate to osimertinib was 78.9%, and the median overall survival was 33.9 months.<br /><br />The researchers also investigated resistance mechanisms to osimertinib. Of the 103 patients who had disease progression on osimertinib, 36.9% had repeat tissue biopsy. Resistance mechanisms identified included histologic transformation (10.5%), cMET amplification (13.2%), C797S mutation (10.5%), and ALK rearrangement (2.6%).<br /><br />Positive smoking history, poor ECOG status, and exon 21 mutations were identified as negative prognostic factors for overall survival. However, cMET polysomy and high PD-L1 status were not significantly associated with survival outcomes.<br /><br />The researchers concluded that osimertinib is an effective first-line treatment for Asian patients with advanced EGFR-mutant NSCLC, with durable overall survival, progression-free survival, and time-to-treatment failure. They also highlighted the importance of repeat tissue biopsy at the time of disease progression to identify resistance mechanisms and guide further treatment decisions.

Asset Subtitle

Wan Ling Tan

Meta Tag

Speaker Wan Ling Tan

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

National Cancer Centre Singapore

osimertinib

first-line treatment

Asian patients

advanced EGFR-mutant non-small cell lung cancer

NSCLC

patient characteristics

baseline brain metastases

overall response rate

resistance mechanisms