Prevalence, Treatment Patterns, and Outcomes of Individuals with EGFR Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion EGFR Mutation Carriers.

Autor: O'Sullivan DE; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Jarada TN; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Yusuf A; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Hu LXY; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Gogna P; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada.; Public Health Sciences, Queen's University, Kingston, Toronto, ON K7L 3N6, Canada., Brenner DR; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Abbie E; Janssen Inc., Toronto, ON M3C 1L9, Canada., Rose JB; Janssen Inc., Toronto, ON M3C 1L9, Canada., Eaton K; Janssen Inc., Toronto, ON M3C 1L9, Canada., Elia-Pacitti J; Janssen Inc., Toronto, ON M3C 1L9, Canada., Ewara EM; Janssen Inc., Toronto, ON M3C 1L9, Canada., Pabani A; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada., Cheung WY; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada., Boyne DJ; Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, Canada.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2022 Sep 30; Vol. 29 (10), pp. 7198-7208. Date of Electronic Publication: 2022 Sep 30.
DOI: 10.3390/curroncol29100567
Abstrakt: Real-world evidence surrounding EGFR positive NSCLC patients in Canada is limited. Administrative databases in Alberta, Canada were used to evaluate EGFR testing and mutation prevalence in de novo metastatic NSCLC, as well as the characteristics, treatment patterns, and outcomes of individuals with Exon 19, L858R and Exon20ins mutations. Between 2013-2019, 2974 individuals underwent EGFR testing, of which 451 (15.2%) were EGFR positive. Among EGFR positive individuals, 221 (49.0%) had an Exon 19 mutation, 159 (35.3%) had an L858R mutation, and 18 (4%) had an Exon20ins mutation. The proportion of individuals who initiated 1L systemic therapy was 89.1% for Exon19, 85.5% for L858R, and 72.2% for Exon20ins carriers. The primary front-line systemic therapy was gefitinib or afatinib monotherapy for individuals with Exon 19 (93.4%) and L858R (94.1%) mutations versus platinum combination therapy for individuals with Exon20ins mutations (61.5%). The Exon20ins cohort had worse median overall survival from initiation of 1L systemic therapy (10.5 months [95% CI: 8.0-not estimable]) than the Exon19 (20.6 months [95% CI: 18.4-24.9]), and L858R cohorts (19.1 months [95% CI: 14.5-23.1]). These findings highlight that Exon20ins mutations represent a rare subset of NSCLC in which treatment options are limited and survival outcomes are worse relative to individuals with more common types of EGFR mutations.
Databáze: MEDLINE
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