Standard-Dose Osimertinib in EGFR-Mutated Non–Small-Cell Lung Adenocarcinoma With Leptomeningeal Disease
| Autor: | Steven Kao, Tessa A. Morris, Mark Voskoboynik, Benjamin Solomon, Luke McLean, Wasek Faisal, Ross Jennens, Sagun Parakh, Craig R. Lewis, Malinda Itchins, Adam R. Broad, Melvin Chin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research Poor prognosis Lung Neoplasms Administration Oral Kaplan-Meier Estimate Disease 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Meningeal Neoplasms medicine Humans LEPTOMENINGEAL DISEASE Osimertinib Epidermal growth factor receptor Protein Kinase Inhibitors Aged Retrospective Studies Aged 80 and over Acrylamides Aniline Compounds Duration of Therapy Lung biology business.industry Middle Aged medicine.disease Progression-Free Survival ErbB Receptors Treatment Outcome 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cancer research biology.protein Adenocarcinoma Female Non small cell business |
| Zdroj: | JCO Precision Oncology. :561-568 |
| ISSN: | 2473-4284 |
| DOI: | 10.1200/po.20.00464 |
| Popis: | 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: | OpenAIRE |
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