2024 World Conference on Lung Cancer (WCLC) - Posters-P2.10B.03 Efficacy of Platinum Pemetrexed in Patients with EGFR Mutated Advanced Lung Cancer after Progression on Osimertinib

P2.10B.03 Efficacy of Platinum Pemetrexed in Patients with EGFR Mutated Advanced Lung Cancer after Progression on Osimertinib - A Prospective Cohort Study

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The OCELOT study investigated the efficacy of platinum-pemetrexed chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) exhibiting EGFR mutations after disease progression on osimertinib, a third-generation TKI. Conducted across multiple Canadian cancer centers, this phase II trial (NCT04335292) evaluated patients with both common (Exon 19 del and L858R) and uncommon EGFR mutations, excluding exon 20 insertions. <br /><br />The study focused on determining the objective response rate (ORR) as the primary outcome, with progression-free survival (PFS) and time to treatment failure (TTF) as secondary outcomes. Among 29 patients who received second-line treatment with platinum-pemetrexed, 22 had evaluable disease, yielding a partial response in 31.8% of the entire cohort and 50% of those with atypical mutations. The disease control rate was high at 81.8% overall, with a median PFS of 6.6 months and median TTF of 7 months.<br /><br />The findings indicate that platinum-pemetrexed as a second-line treatment in EGFR-mutated advanced NSCLC patients post-osimertinib progression shows results comparable to earlier studies (e.g., MARIPOSA, Keynote-789, AURA3). The patients achieved a high ORR and PFS, suggesting that the benefit of this chemotherapy regimen translates effectively when dosing is determined by the discretion of the investigators in a more pragmatic clinical setting.<br /><br />This study underscores the potential of platinum doublet chemotherapy as a viable treatment option post-osimertinib, providing a benchmark for similar pragmatic approaches in clinical oncology. The OCELOT study was funded by a grant from AstraZeneca, with acknowledgments to Calian Clinical Research and all participating patients and families.

Asset Subtitle

Saurav Verma

Meta Tag

Speaker Saurav Verma

Topic Metastatic NSCLC – Cytotoxic Therapy

Keywords

OCELOT study

platinum-pemetrexed chemotherapy

non-small cell lung cancer

EGFR mutations

osimertinib progression

objective response rate

progression-free survival

disease control rate

second-line treatment

clinical oncology