Tyrosine kinase inhibitors (TKI) are the standard of treatment in first line for advanced EGFR-mutated NSCLC. Few data exist about their tolerance and efficacy in octogenarians particularly in Caucasian population. The purpose of this multicentric real world study was to assess tolerance and efficacy of EGFR-TKI in this population.
We retrospectively identified patients aged 80 years or older with EGFR-mutated NSCLC treated by EGFR-TKI between 01/01/2011 and 31/03/2015 whatever the line of treatment. Patients were described according to their clinical characteristics, management and outcomes (progression-free survival (PFS) and overall survival (OS).
The 20 french participating centers included 114 patients: 77% were women, the median age was 83,9 ±3,9 years; 98,2% were caucasians and 84,6% were home life (45% had home help), 71% took more than 5 drugs/d. Respectively 64%,17.5% and 8,5% of patients had a performance status of 0-1/2/3 at diagnosis. 76% of them were non-smokers, 95,6% had adenocarcinomas; 80%/13%/7% had respectively stage IV/III/II–I at treatment initiation. EGFR mutations were identified on exon 19 (46,5%), exon 21 (40,3%), exon 20 (5,2%). A geriatric assessment was assessed in 35% of cases. Median time between first symptoms and diagnosis was 55 days. 97.3% of the patients were treated by TKI as first or second line. Median PFS was 11,9 months, 95% CI: 8,6-14,7. Response and disease control rates were 67% and 79% respectively. In 40% of the cases EGFR-TKI treatment was maintain beyond progression. After progression, 44,7% of the patients received another line of treatment (chemotherapy: 44,7%). Median OS was 20,9 months, 95% CI: 14,3-27,1. Main toxicities were cutaneous: 66% (grade 3/4:10%), diarrhea 56% (grade 3/4:15%, grade 5: 2%), others 25,6% (grade 3/4: 41%).
In this real-world analysis, compared to younger, octogenarians patients with EGFR-mutated NSCLC treated by EGFR TKI present comparable outcomes and toxicity profile. Geriatric assessment is still under-used in this population.
Clinical trial identification
IRBN 112016/CHUSTE CCTIRS N°15.779
Legal entity responsible for the study
Groupe Français de Pneumo Cancérologie (GFPC)
R. Corre: In the last five years, has received honoraria for attending scientific meetings, speaking, organizing research or consulting from Roche, Astra-Zeneca, Boehringer-Ingelheim, Lilly, Bristol-Myers-Squibb, Novartis. H. Doubre: In the last five years, has received honoraria for attending scientific meetings, speaking, organizing research or consulting, from Astra-Zeneca, Novartis, Lilly, Boehringer-Ingelheim, Roche, Leo Pharma. C. Chouaid: In the past 5 years, has received fees for attending scientific meetings, speaking, organizing research or consulting from AZ, Boehringer Ingelheim, and Roche. J.B. Auliac: In the last five years, has received honoraria for attending scientific meetings, speaking, organizing research or consulting, from Boehringer Ingelheim, Hoffman-Roche, BMS, Lilly and Pfizer. All other authors have declared no conflicts of interest.