Real-world implementation of sequential targeted therapies for EGFR-mutated lung cancer.

BACKGROUND

Epidermal growth factor receptor-mutated (EGFR

METHODS

EGFR

RESULTS

A total of 207 patients received erlotinib (37%), gefitinib (16%) or afatinib (47%). The median age was 66 years, with a predominance of female (70%), never/light-smokers (69%). T790M testing was performed in 174/202 progressive cases (86%), positive in 93/174 (53%), and followed by osimertinib in 87/93 (94%). Among the 135 deceased patients, 94 (70%) received subsequent systemic treatment (43% chemotherapy, 39% osimertinib), while 30% died without, either before (4%) or after progression, due to rapid clinical deterioration (22%), patient refusal of further therapy (2%), or severe competing illness (2%). Lack of subsequent treatment was significantly (4.5x,

CONCLUSION

Osimertinib after 1G/2G TKI failure prolongs survival, but approximately 15% and 30% of patients forego molecular retesting and subsequent treatment, respectively, mainly due to rapid clinical deterioration. This is an important remediable obstacle to sequential TKI treatment for EGFR

Informations de copyright

© The Author(s), 2021.

Déclaration de conflit d'intérêts

Conflict of interest statement: FB reports personal fees from Novartis, MSD, Chugai Pharma, Roche, and AstraZeneca and research grants from AstraZeneca, BMS, and Roche. ALV reports personal fees from AstraZeneca. DK reports personal fees from AstraZeneca, personal fees from Bristol-Myers Squibb GmbH, personal fees from Pfizer Pharma GmbH, outside the submitted work. FJH reports advisory board fees and honoraria from Lilly, Roche, AstraZeneca, Novartis, Boehringer, Chiesi, Teva, Pulmonx BTG, and Olympus as well as research funding from Lilly, Roche, AstraZeneca, Novartis, Boehringer, Chiesi, and Teva. CPH reports consultation, lecture and other fees from Novartis, Basilea, Bayer, Grifols, Boehringer, Pierre Fabre, Covidien, Siemens, Chiesi, Intermune, MEDA Pharma, Bracco, Pfizer, MSD, Roche, Lilly, AstraZeneca, Schering-Plough, Essex, Gilead, MeVis, Fresenius, and Astellas as well as ownership of GSK stocks TM reports research funding from Roche and patents with Roche. JRF reports advisory board honoraria from Boehringer, Roche, Celgene, and AstraZeneca. PS reports advisory board honoraria from Pfizer, Roche, Novartis, and AstraZeneca as well as speaker’s honoraria and research funding from Roche, AstraZeneca, and Novartis. AS reports advisory board honoraria and/or speaker fees: Astra Zeneca, Bayer, Eli Lilly, Roche, BMS, Illumina, MSD, Novartis, Pfizer, Seattle Genetics, Takeda, and Thermo Fisher, and research grants from BMS, Bayer, and Chugai. MT reports advisory board honoraria from Novartis, Lilly, BMS, MSD, Roche, Celgene, Takeda, AbbVie, Boehringer, speaker’s honoraria from Lilly, MSD, Takeda, research funding from AstraZeneca, BMS, Celgene, Novartis, Roche and travel grants from BMS, MSD, Novartis, Boehringer. PC reports lecture/advisory board fees from AstraZeneca, Boehringer, Chugai, Novartis, Pfizer, Roche and Takeda, as well as research funding from AstraZeneca, Novartis, Roche, and Takeda.