2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12A.14 Multicentered Real-World Evidence of Osimertinib Treatment in EGFR-Mutant Advanced Non-Small Cell Lung Cancer (NSCLC) In Thailand

EP.12A.14 Multicentered Real-World Evidence of Osimertinib Treatment in EGFR-Mutant Advanced Non-Small Cell Lung Cancer (NSCLC) In Thailand

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The study presented by Thanaporn Thamrongjirapat and colleagues investigated the real-world application of osimertinib in treating patients with EGFR-mutant advanced non-small cell lung cancer (NSCLC) in Thailand. This multicentric study analyzed data from five university-based hospitals, involving 483 patients treated with osimertinib between 2015 and 2023. <br /><br />Osimertinib, a third-generation EGFR-TKI, stands out due to its use primarily for patients with the EGFR T790M mutation. However, cost policies in Thailand restrict its reimbursements to patients using Civil Servant Medical Benefits Scheme (CSMBS); others must pay out-of-pocket.<br /><br />Key findings include:<br /><br />1. **Patient Demographics**: The majority were female (70%), non-smokers (70%), with a median age of 66.<br /><br />2. **Treatment Usage**: Only 17% received osimertinib as a first-line (1L) treatment, while 54% took it as a second-line (2L) therapy. Liquid biopsy was the prevalent method (67.4%) for diagnosing the T790M mutation.<br /><br />3. **Efficacy**: First-line treatment showed a progression-free survival (PFS) of 25.3 months against 11 months in second-line treatment, a significant difference (P=0.001). However, overall survival (OS) times didn't significantly differ between lines of treatment (P=0.792).<br /><br />4. **Response Rates and Safety**: The overall response rate (ORR) was higher for 1L than for 2L treatments (74% vs. 50%, P=0.001). Adverse events occurred in 18% of patients, primarily mild (grade 1-2), with only three cases of severe pneumonitis.<br /><br />5. **Practical considerations**: Patients on state enterprise plans or those self-funding had better OS than those under universal coverage. Interestingly, dose reduction/interruptions seemed to correlate with longer OS.<br /><br />The study concludes that osimertinib's real-world performance aligns with clinical trial results, particularly benefiting when used as a first-line treatment. It presents a viable option for second or subsequent lines, crucial for resource-limited settings.

Asset Subtitle

Thanaporn Thamrongjirapat

Meta Tag

Speaker Thanaporn Thamrongjirapat

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

osimertinib

EGFR-mutant

non-small cell lung cancer

NSCLC

Thailand

T790M mutation

progression-free survival

overall response rate

adverse events

real-world application