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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

5483 - Which is better EGFR-TKI followed by osimertinib between afatinib and gefitinib/erlotinib?

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Presenters

Motohiro Tamiya

Citation

Annals of Oncology (2018) 29 (suppl_8): viii493-viii547. 10.1093/annonc/mdy292

Authors

M. Tamiya1, A. Tamiya2, H. Suzuki3, K. Nakahama2, Y. Taniguchi2, K. Kunimasa1, M. Kimura1, T. Inoue1, K. Nishino1, T. Hirashima3, S. Atagi2, F. Imamura1, T. Kumagai1

Author affiliations

  • 1 Thoracic Oncology, Osaka International Cnacer Institute, 541-8567 - Osaka/JP
  • 2 Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, 591-8555 - Sakai/JP
  • 3 Thoracic Malignancy, Osaka Habikino Medical Center, 583-8588 - Habikino/JP
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Resources

Abstract 5483

Background

In epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC), there are various treatment challenges. Most patients develop resistance and relaps within 1-1.5 years after first-line EGFR- tyrosine kinase inhibitor (TKI) treatment [1st- and 2nd- generation (G) TKIs]. Some studies suggest that afatinib may overcome the tumor heterogeneity.

Methods

We conducted the multi-center retrospective study in patients with EGFR-mutant NSCLC after acquired resistance to EGFR-TKIs appeared at any line of therapy. The outcomes between afatinib followed by osimertinib and 1st-G EGFR TKIs followed by osimertinib (3rd-G EGFR TKI) were evaluated.

Results

We enrolled 111 T790M mutation-positive patients treated with osimertinib. The median age was 69 (range: 39-88) year old. Among them, 33 (29.7%) were male, 100 (90%) were with PS 0-1, and 35 (31.5%) were treated with afatinib followed by osimertinib. The median treatment line with afatinib or 1st-G EGFR TKI followed by osimertinib was 5 or 4. In all patients, the objective response and disease control rates were 63.1% and 77.5%, respectively. The objective response and disease control rates were significantly higher in patients with afatinib followed by osimertinib than in those with 1st-G EGFR TKI followed by osimertinib [82.9% vs 53.9% (p = 0.0065) and 91.4% vs 71.1% (p = 0.032)], respectively. The median PFS (with <60% events) was longer and in favor of afatinib followed by osimertinib compared with 1st-G EGFR TKI followed by osimertinib (15.7 vs 8.9 months, p = 0.195). The follow-up is still ongoing.

Conclusions

Afatinib followed by osimertinib may provide better clinical benefit for NSCLC patients harboring T790M mutation compared with 1st-G EGFR TKIs. Afatinib followed by osimertinib is one of the first line sequential options even if osimertinib can be used as a first line therapy.

Clinical trial identification

Legal entity responsible for the study

M. Tamiya.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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