Negative impact of malignant effusion on osimertinib treatment for non-small cell lung cancer harboring EGFR mutation

Autor: Hirotsugu Kenmotsu, Haruyasu Murakami, Tateaki Naito, Takahisa Kawamura, Shota Omori, Keita Mori, Kazushige Wakuda, Haruki Kobayashi, Kazuhisa Nakashima, Akira Ono, Toshiaki Takahashi, Masahiro Endo
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Oncology
Lung Neoplasms
0302 clinical medicine
Non-small cell lung cancer
Malignant effusion
Epidermal growth factor
Carcinoma
Non-Small-Cell Lung
Pharmacology (medical)
Osimertinib
Aged
80 and over
Aniline Compounds
Middle Aged
Prognosis
ErbB Receptors
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Adult
medicine.medical_specialty
Short Report
Antineoplastic Agents
03 medical and health sciences
EGFR-TKI
Internal medicine
medicine
Humans
Lung cancer
Aged
Retrospective Studies
Pharmacology
Acrylamides
Lung
business.industry
medicine.disease
Confidence interval
Pleural Effusion
Malignant
respiratory tract diseases
030104 developmental biology
Drug Resistance
Neoplasm
Egfr mutation
Mutation
business
Progressive disease
Follow-Up Studies
Zdroj: Investigational New Drugs
ISSN: 1573-0646
0167-6997
Popis: Summary 3rd-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), including osimertinib, have reasonable efficacy in non–small-cell lung cancers (NSCLC) with EGFR mutations. However, the efficacy of osimertinib in NSCLC patients with fluids, such as pleural, pericardial and abdominal effusions, is unclear. We evaluated the efficacy of osimertinib in this specific setting. NSCLC patients harboring EGFR T790 M mutations who experienced progressive disease after first EGFR-TKI treatment and started osimertinib treatment between April 2016 and August 2018 were retrospectively screened. In particular, we assessed the efficacy of osimertinib for NSCLC with EGFR T790 M mutations in patients who were diagnosed with EGFR T790 M mutation by malignant effusion. Among 90 patients with EGFR T790 M mutation who started osimertinib treatment after EGFR-TKI failure, 21 were diagnosed from malignant effusions excluding cerebrospinal fluid (F group) and 69 using other methods including tissue biopsies (NF group). Patient characteristics were well-balanced between the two groups. Overall response was 50%, and significantly worse in the F group (29%) than the NF group (57%; P = 0.025). Median progression-free survival with osimertinib treatment in the F group (7.1 months, 95% confidence interval [CI]: 2.3–14.0) was significantly shorter than that in the NF group (11.9 months, 95% CI: 9.5–16.0; P = 0.046)). Median drainage-free time was 10.9 months (95% CI: 1.4 months– not reached). The present study showed that the efficacy of osimertinib for NSCLC in which EGFR T790 M mutation is detected by malignant effusion may be less than in EGFR T790 M-mutated NSCLC detected by other methods.
Databáze: OpenAIRE
Externí odkaz: