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Poster display session

4605 - Overall survival (OS) in patients (pts) with EGFR T790M-positive advanced non small cell lung cancer (NSCLC) treated with osimertinib: results from two Phase II studies

Date

09 Sep 2017

Session

Poster display session

Presenters

Tetsuya Mitsudomi

Citation

Annals of Oncology (2017) 28 (suppl_5): v460-v496. 10.1093/annonc/mdx380

Authors

T. Mitsudomi1, M. Ahn2, L.2. Bazhenova3, F. Blackhall4, T. Hida5, M. Majem Tarruella6, S.L. Vowler7, G. Laus8, P.A. Jänne9, J.C. Yang10

Author affiliations

  • 1 Thoracic Surgery, Kindai University School of Medicine, 577-8502 - Osaka/JP
  • 2 Samsung Medical Center, Sungkyunkwan University School of Medicine, 135-710 - Seoul/KR
  • 3 Uc San Diego Health, Moores Cancer Center, San Diego/US
  • 4 The Christie Nhs Foundation Trust And Division Of Molecular And Clinical Cancer Services, University of Manchester, M20 4BX - Manchester/GB
  • 5 Department Of Thoracic Oncology, Aichi Cancer Center, 464-8681 - Nagoya/JP
  • 6 Medical Oncology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
  • 7 Biostatistics And Informatics, AstraZeneca, Cambridge/GB
  • 8 Global Medicines Development, AstraZeneca, Cambridge/GB
  • 9 Lowe Center For Thoracic Oncology, Dana Farber Cancer Institute  , Boston, MA/US
  • 10 Cancer Research Center, National Taiwan University, Taipei/TW
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Resources

Abstract 4605

Background

Osimertinib is an oral, potent, CNS active, irreversible EGFR-TKI approved to treat pts with T790M-positive advanced NSCLC. Here we present updated data from a pre-planned pooled analysis of Phase II studies: AURA extension (NCT01802632), AURA2 (NCT02094261).

Methods

Pts with centrally confirmed T790M-positive (by cobas® EGFR Mutation Test) advanced NSCLC, who had progressed following EGFR-TKI treatment, received osimertinib 80 mg once daily. Other inclusion criteria were measurable disease, WHO performance status 0/1 and acceptable organ function. Pts with stable CNS metastases were eligible. The primary efficacy endpoint was objective response rate (ORR) by RECIST 1.1 per blinded independent central review (BICR). Secondary endpoints included duration of response (DoR), progression-free survival (PFS), OS and safety.

Results

As of the 1 Nov 2016 data cut-off (DCO) 411 pts had received osimertinib (129 pts as second-line and 282 pts as ≥third-line); median treatment exposure was 16.4 months (mo; range 0–29.7 mo). Pooled results (BICR) were: ORR (evaluable for response set; EFR), 66% (95% confidence interval [CI] 61, 70); median DoR (EFR), 12.3 mo (95% CI 11.1, 13.8); median PFS (full analysis set), 9.9 mo (95% CI 9.5, 12.3). At DCO, 188 pts (46%) had died, 191 pts (47%) remained in survival follow up, and 32 pts (8%) had discontinued before death. Pooled median OS was 26.8 mo (95% CI 24.2, not calculable [NC]); median OS in the second-line and ≥third-line cohorts (95% CI) was 25.8 mo (24.0, NC) and NC (22.1, NC), respectively. The 12 and 24 mo survival rates were 80% and 56%, respectively. The most common (investigator assessed) possibly causally-related adverse events (AEs) were rash (grouped term 42%, [grade ≥3, 1%]) and diarrhoea (39% [

Conclusions

With a median treatment exposure of 16.4 mo, osimertinib resulted in a median OS of 26.8 mo. This pooled analysis represents the most mature clinical trial data for osimertinib in pts with pre-treated T790M positive advanced NSCLC, and further establishes osimertinib as standard of care in this setting.

Clinical trial identification

AURA extension (NCT01802632), AURA2 (NCT02094261)

Legal entity responsible for the study

AstraZeneca

Funding

AstraZeneca

Disclosure

T. Mitsudomi: Honoraria: AstraZeneca, Boehringer- Ingelheim, Chugai Research grant: Boehringer-Ingelheim, Chugai. L. Bazhenova: Advisory board: AstraZeneca. F. Blackhall: Honoraria: AstraZeneca, Pfizer, Boehringer Ingelheim, Medivation, Novartis, MSD, BMS Consulting/Advisory role: Medivation, Roche. Research funding: AstraZeneca, Pfizer, Boehringer Ingelheim, Medivation, Novartis, MSD, BMS. Expense: Boehringer Ingelheim. T. Hida: Research funding and honoraria: Chugai Pharmaceutical, Novartis Pharma, Taiho Pharmaceutical, AstraZeneca, Nippon Boehringer Ingelheim, Clovis Oncology, Astellas. M. Majem Tarruella: Advisory Board: Novartis, Roche, Pfizer, Bristol-Myers Squibb, Boehringer Ingelheim. S.L. Vowler, G. Laus: Employee of AstraZeneca. P.A. Jänne: AstraZeneca – consulting and sponsored research Boehringer Ingelheim – consulting Pfizer – consulting Roche/Genentech – consulting Chugai Pharmaceuticals – consulting ARIAD – consulting Astellas – sponsored research. J.C-H. Yang: Honorarium/Ad board: Boehringer Ingelheim, Eli Lilly, Bayer, Roche/Genentech/Chugai, Astellas, MSD, Merck Serono, Pfizer, Novartis, Clovis Oncology, Celgene, Merrimack, Yuhan Pharma, BMS, Ono pharma Daiichi Sankyo, AstraZeneca, Hansoh Pharmaceuticals. All other authors have declared no conflicts of interest.

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