Standard-Dose Osimertinib in EGFR-Mutated Non-Small-Cell Lung Adenocarcinoma With Leptomeningeal Disease.

Autor:	McLean LS; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Faisal W; Department of Medical Oncology, Ballarat Health Services, Ballarat, Victoria, Australia., Parakh S; Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia., Kao SC; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia., Lewis CR; Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.; Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia., Chin MT; Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.; Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia., Voskoboynik M; Department of Medical Oncology, Alfred Health, Melbourne, Victoria, Australia.; Central Clinical School, Monash University, Melbourne, Victoria, Australia., Itchins MJ; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia., Jennens RR; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.; Department of Medical Oncology, Epworth Health, Melbourne, Victoria, Australia., Broad AR; Department of Medical Oncology, Andrew Love Cancer Centre, Geelong, Victoria, Australia., Morris TA; Southern Blood and Cancer Service, Dunedin, New Zealand.; Department of Medicine, University of Otago, Dunedin, New Zealand., Solomon BJ; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	JCO precision oncology [JCO Precis Oncol] 2021 Nov; Vol. 5, pp. 561-568.
DOI:	10.1200/PO.20.00464
Abstrakt:	Purpose: Leptomeningeal disease (LMD) in epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma is associated with a poor prognosis and limited treatment options. Osimertinib is a potent third-generation EGFR tyrosine kinase inhibitor with confirmed CNS penetration. This study reports on outcomes of patients with EGFR-mutated non-small-cell lung cancer who developed LMD and were subsequently treated with osimertinib. Methods: We identified patients treated with osimertinib 80 mg PO daily under a compassionate access scheme across nine tertiary Australian institutes between July 2017 and July 2020. Patient demographics, tumor characteristics, and treatment history were collected. Median overall survival, median progression-free survival, disease control rates (DCR), and overall response rates (ORR) were assessed. Kaplan-Meier analysis was performed and descriptive statistics were used. Results: Thirty-nine patients were analyzed of which 74% were female. Exon 19 deletions (49%) and L858R point mutations (41%) were the most common EGFR mutations. Forty-nine percentage of patients were Eastern Cooperative Oncology Group 1. The median duration of osimertinib therapy was 6 months. The extracranial DCR and ORR were 60% and 54%, and the intracranial DCR and ORR were 68% and 53%, respectively. Median overall survival was 10.5 months (95% CI, 8.17 to 15.05 months). Conclusion: There are limited treatment options for LMD in EGFR-positive lung cancer, and osimertinib at a dose of 80 mg daily is an active therapeutic option for these patients.
Databáze:	MEDLINE
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