2025 Targeted Therapies of Lung Cancer (TTLC) - Posters-PP01.30 Predictors of poor progression-free survival among Canadian patients with advanced EGFR-mutated non-small cell lung cancer treated with first-line osimertinib in a real-world setting

PP01.30 Predictors of poor progression-free survival among Canadian patients with advanced EGFR-mutated non-small cell lung cancer treated with first-line osimertinib in a real-world setting

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This study aims to identify predictors of poor progression-free survival (PFS) among Canadian patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC) treated with first-line osimertinib monotherapy. Researchers used data from the CARMA-BROS network, which collects real-world data from cancer centers across Canada, to conduct a retrospective cohort study at four centers across Ontario, Quebec, and Nova Scotia, involving 151 patients.<br /><br />Key findings show that the real-world progression-free survival (rwPFS) for these patients is consistent with clinical trial data. However, certain factors are associated with worsened rwPFS. Male patients, those with TP53 co-mutations, patients with EGFR L858R mutations, and those with central nervous system (CNS) metastases exhibit significantly worse outcomes. The median rwPFS was 16.3 months, with a notable decline in survival across different time intervals.<br /><br />Statistical analyses using Kaplan-Meier curves and multivariable Cox proportional hazards models reveal that male sex has a hazard ratio (HR) of 1.50 (p=0.049), TP53 mutation carries an HR of 1.92 (p=0.011), and CNS metastases an HR of 2.10 (p=0.001), suggesting these are independent prognostic factors for worse rwPFS. Moreover, patients with the TLR L858R mutation had an HR of 1.52 (p=0.036), indicating significantly poorer progression compared to those with the Exon 19 deletion mutation.<br /><br />Overall, the study emphasizes the critical influence of specific genetic mutations and demographic factors on the treatment outcomes of NSCLC patients on osimertinib, highlighting the need for personalized treatment strategies to optimize patient outcomes. The findings support ongoing research and tailored therapeutic approaches in treating advanced EGFR-mutated NSCLC in the real-world setting.

Asset Subtitle

Samir Barghout

Keywords

progression-free survival

EGFR-mutated NSCLC

osimertinib monotherapy

CARMA-BROS network

real-world data

TP53 co-mutations

CNS metastases

Kaplan-Meier curves

Cox proportional hazards

personalized treatment