Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer.

Autor: Auliac JB; Service de Pneumologie et Oncologie Thoracique, Hôpital F. Quesnay, 2 Boulevard de Sully, 78200, Mantes-la-Jolie, France. j-b.auliac@ch-mantes-la-jolie.fr., Saboundji K; Pneumologie, CH François Quesnay, Mantes-la-Jolie, France., Andre M; Pneumologie, CHU Saint Denis, site Félix Guyon, Réunion, France., Madelaine J; Pneumologie, CHU Caen Normandie, Caen, France., Quere G; Pneumologie, CHRU Brest, site Hôpital Morvan, Brest, France., Masson P; Pneumologie, CH Cholet, Cholet, France., Vergnenegre A; Pneumologie, CHU Limoges, Limoges, France., Lamy R; Oncologie, CH Bretagne Sud, Lorient, France., Raymond S; Pneumologie, Hôpital Robert Schuman, Metz, France., Chiappa AM; Pneumologie, CH de Cornouaille, Quimper, France., Hauss PA; Pneumologie, CH Elbeuf, Saint-Aubin-lès-Elbeuf, France., Fournel P; Oncologie, Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France., Corre R; Pneumologie, Hôpital Pontchaillou, Rennes, France., Chouaid C; Service de Pneumologie et Oncologie Thoracique, Hôpital F. Quesnay, 2 Boulevard de Sully, 78200, Mantes-la-Jolie, France.
Jazyk: angličtina
Zdroj: Targeted oncology [Target Oncol] 2019 Jun; Vol. 14 (3), pp. 307-314.
DOI: 10.1007/s11523-019-00646-4
Abstrakt: Background: The resistance mutation T790M is reported in 50-60% of patients pretreated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Osimertinib has been approved in these patients, but data in octogenarians remain rare.
Objective: The objective of this retrospective analysis was to evaluate in real life the efficacy of osimertinib in a population of octogenarian patients.
Methods: This retrospective multicentric study included pretreated octogenarian patients with EGFR T790M-mutated advanced non-small cell lung cancer (NSCLC) in the setting of the French early access program for osimertinib. The primary endpoints were progression-free survival (PFS) and overall survival (OS) from osimertinib initiation.
Results: In total, 43 patients were included (mean age 84.6 years; women 90.7%: adenocarcinoma 100%; never smokers 90.5%; at osimertinib initiation: performance status ≥ 2, 42.4%; stage 4, 93.0%; brain metastases 16.3%). Patients received a median of two lines of treatment before osimertinib initiation, and all received first- or second-generation EGFR TKIs before osimertinib (first line in 79.1%). Osimertinib was used as a second-line treatment in 41.9% of cases and third line or more in 58.1%. Median PFS was 17.5 (95% confidence interval [CI] 12.2-19.0) months for the entire population: 20.6 (95% CI 18.8-not reached) months in patients with brain metastases and 16.7 (95% CI 10.4-18.9) months in patients without (p = 0.1). There was no significant difference for osimertinib treatment as second or third line or more (17.1 vs. 18.6 months, respectively). OS was 22.8 (95% CI 15.7-not reached) months from osimertinib initiation.
Conclusion: The efficacy of osimertinib as second-line treatment or more in octogenarian pretreated patients with EGFR T790M-mutated advanced NSCLC in a real-life setting was similar to that in randomized controlled trials.
Databáze: MEDLINE
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