1287P - Retrospective multicenter study in non small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) activating mutation tre...
| Date | 27 September 2014 |
| Event | ESMO 2014 |
| Session | Poster Display session |
| Topics | Anti-Cancer Agents & Biologic Therapy Non-Small-Cell Lung Cancer, Metastatic Personalised Medicine |
| Presenter | Jean Bernard Auliac |
| Citation | Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349 |
| Authors |
J.B. Auliac1, C. Fournier2, C. Audigier Valette3, M. Perol4, A. Bizieux5, I. Monnet6, C. Decroisette Phan van Ho7, S. Bota Ouchlif8, R. Corre9, G. Le Garff10, P. Fournel11, N. Baize12, R. Lamy13, A. Vergnenegre14, D. Arpin15, B. Marin16, L. Greillier17, R. Gervais18
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Abstract
Aim
Background: EGFR-TKI are a standard treatment for patients (pts) with NSCLC harboring activating EGFR mutations. All pts develop acquired resistance. At progression, the standard treatment is chemotherapy. Retrospective studies suggest that continuous use of EGFR-TKI beyond progressive disease (PD) may benefit some pts. Objective: The purpose of our retrospective multicentric study is to determine the frequency of continuation of EGFR-TKIs beyond RECIST-PD, and investigate the association of pts and disease characteristics with continuation of EGFR-TKIs at progression.
Methods
Main inclusion criteria were: pts with NSCLC and activating EGFR mutations, EGFR-TKIs as their initial systemic therapy received between January 2010 and July 2012, Measurable lesion according to RECIST 1.1, acquired resistance to EGFR-TKI according to Jackman's criteria. Following data were collected: demographic and clinical data, Progression free survival (PFS), Overall Survival (OS), mutational status, mode of progression, therapeutic approach at PD. A comparison of clinical data and outcome of pts receiving EGFR-TKI beyond PD (group 1) versus discontinuing EGFR-TKI at PD (group 2) was made.
Results
133 pts were recruited in 29 centers: age 69 ± 12.7 years, female 67.6%, EGFR mutation exon 19/21/others: 65.4 %/ 30.8%/ 3.8%, adenocarcinoma 98%, never smokers 68.5%, PS 0/1: 80,5%. First line treatment: gefitinib 77.4%, erlotinib 21.8%. 40.6% pts continued EGFR-TKI beyond RECIST-PD (25,6% EGFR-TKI alone, 15% EGFR-TKI combined with local treatment). 59.3% pts changed treatment (39.8% chemotherapy, 7.5% combination chemotherapy +EGFR-TKI, 12% BSC). Median PFS was 9,4 (CI95% :8-10,9) months and median OS was 21,6 (CI95%18,7-25,8) months in the entire population. In group 1 and 2, m PFS was 10,1 (CI95% :7,7-12,3) and 8,7 (CI 95% :7,5-10,9) (p = 0,34) months and m OS was 23 and 20,4 months respectively (p = 0,08). All comparative data between groups 1 and 2, univariate and mutivariate analysis will be presented.
Conclusions
This large retrospective study confirms that, in some circumstances, continuous use of EGFR-TKI beyond PD does not hamper OS and should be considered.Prospective studies will help to determine which patients benefit more this strategy. Clinical trial information: Supported by an academic grant from boehringer ingelheim, Hoffman Roche.
Disclosure
J.B. Auliac: In the last five years, JB Auliac has received honoraria for attending scientific meetings, speaking, organizing research or consulting, from Boehringer Ingelheim, Hoffman-Roche, Lilly and Pfizer; C. Decroisette Phan van Ho: consultancy Hoffman roche; S. Bota Ouchlif: travel/accomodation meeting: Lilly; R. Corre: board membership: roche, lilly consultancy: roche, lilly travel/accommodations meeting: lilly, roche; P. Fournel: consultancy: roche, lilly, boehringer ingelheim; A. Vergnenegre: consultancy: roche grants/grants pending:roche, lilly, boehringer; L. Greillier: consultancy: roche, lilly grants/grants pending: roche travel/accommodation meeting: lilly, roche; R. Gervais: consultancy: Roche, Astra Zeneca et Boehringer ingelheim. All other authors have declared no conflicts of interest.