2023 World Conference on Lung Cancer (Posters)-P2.09. Efficacy of Osimertinib (OSI) vs 1st-Generation TKI Followed by OSI by Clinical Profile in EGFR-Mutant NSCLC (SMILE STUDY)

P2.09. Efficacy of Osimertinib (OSI) vs 1st-Generation TKI Followed by OSI by Clinical Profile in EGFR-Mutant NSCLC (SMILE STUDY) - PDF(Abstract)

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This study examined the efficacy of osimertinib versus a sequence of first-generation TKI followed by osimertinib in patients with metastatic non-small cell lung cancer (NSCLC) who had EGFR mutations. The study included 300 patients who were treated with either osimertinib or the sequence treatment. The primary endpoint was progression-free survival (PFS) of the global strategy, defined as the time between the start of first-line treatment and progression after second-line treatment or death. <br /><br />The results showed that among the patients treated with osimertinib upfront, the median first-line PFS was 19.0 months compared to 16.8 months in the sequence treatment group. The overall survival (OS) was not reached in the osimertinib group compared to 43.8 months in the sequence group. The response rate in the first-line treatment was similar in both groups. However, the sequence group had a longer PFS of the global strategy compared to the osimertinib group, particularly in patients with low tumor burden, no liver metastases, or no CNS involvement. On the other hand, osimertinib upfront was associated with a better PFS of the global strategy in poor-prognosis groups, including patients with high tumor burden, CNS or liver involvement, and poor performance status.<br /><br />In conclusion, this real-life study demonstrated that osimertinib upfront had a prolonged first-line PFS compared to the sequence treatment. The sequence treatment was associated with a longer PFS of the global strategy in certain subgroups of patients, while osimertinib upfront was more effective in poor-prognosis groups. These findings suggest that the choice of treatment strategy should be based on the clinical profile of the patient.

Asset Subtitle

Laura Mezquita

Meta Tag

Speaker Laura Mezquita

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

osimertinib

first-generation TKI

metastatic non-small cell lung cancer

EGFR mutations

progression-free survival

global strategy

overall survival

response rate

tumor burden

clinical profile