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
  • 1Pulmonology Department, hopital Quesnay, 78200 - mantes la jolie/FR
  • 2Mutltidisciplinary Oncology And Therapeutic Innovations, Assistance publiquedes hopitaux de Marseille, marseille/FR
  • 3Oncology, C.H.I.T.S. Font-Pré Centre Hospitalier Intercommunal Toulon La Seyne sur Mer), toulon/FR
  • 4Medical Oncology, Centre Léon Bérard, Lyon/FR
  • 5Pulmonology Department, CHD Les Oudairies, La roche sur yon/FR
  • 6Pulmonology, Centre Hospitalier intercommunal de creteil, 94010 - creteil/FR
  • 7Centre Hospitalier De La Région D'annecy-chra (pringy), Centre Hospitalier de la Région d'Annecy-CHRA (Pringy), prigny/FR
  • 8Clinique Pneumologique, CHU Hôpitaux de Rouen-Charles Nicolle, rouen/FR
  • 9Pulmonology Department, CHU Pontchaillou, rennes/FR
  • 10Pulmonology Department, hopital saint brieuc, saint brieux/FR
  • 11Département D'oncologie Médicale, Institut de Cancérologie Lucien Neuwirth, 42271 - Saint-Priest en Jarez/FR
  • 12Pneumologie, C.H.U. Angers, 49933 - ANGERS/FR
  • 13Pulmonology, Centre Hospitalier de Bretagne Sud, Lorient/FR
  • 14Service De Pneumologie, Hopital du CluzeauCHU Dupuytren, FR-87042 - Limoges CEDEX/FR
  • 15Pulmonology, Centre Hospitalier de Macon, Macon/FR
  • 16Unité Fonctionnelle De Recherche Clinique Et Biostatistique, Facultés De Médecine Et De Pharmacie, chu limoges, limoges/FR
  • 17Multidisciplinary Oncology & Therapeutic Innovations, Aix-Marseille Univ, Assistance Publique-Hôpitaux de Marseille, Marseille/FR
  • 18Oncology Department, Centre François Baclesse, caen/FR

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.