Abstract 370P
Background
1st/2nd generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is associated with poor outcomes in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) harboring EGFR mutations with co-mutations. We aim to explore the efficacy and safety of third-generation TKI aumolertinib in EGFR-mutant NSCLC patients with co-mutations.
Methods
We retrospectively collected data from 52 EGFR-mutant NSCLC patients with co-mutations between April 2020 and June 2022 in the Affiliated Brain Hospital of Nanjing Medical University. The primary endpoint is objective response rate (ORR). The secondary endpoints included progression free survival (PFS), overall survival (OS), disease control rate (DCR) and safety.
Results
Median age was 65 years (ranged 32-84), 61.5 % were female, 84.6 % received aumolertinib monotherapy, 5.8 % received aumolertinib plus bevacizumab and 9.6 % received aumolertinib plus pemetrexed. ORR and DCR for patients receiving aumolertinib monotherapy was 65.9 % and 95.5 %, respectively. In the subgroup analysis of genotypes, ORR and DCR was 71.4 % and 100 % in TP53 mutation, 72.4 % and 100 % in cell cycle signaling pathway related genes, 66.7 % and 100 % in PIK3CA co-mutation, 83.3 % and 97.7 % in PD-L1 TPS 0-1, 55.6 % and 100 % in PD-L1 TPS ≥ 1 (Efficacy; Table). Meanwhile, aumolertinib combination therapy showed superior antitumor activity (ORR: 87.5 % , DCR: 100 %). Both PFS and OS have not been reached. Rash and diarrhea (1-2 grade) were observed in 5.8 % (3/52) and 7.7 % (4/52) patients. Grade ≥ 3 adverse events were observed in 3.8 % (2/52) patients. Table: 370P
| Patients (No.) | ORR (%) | DCR (%) | |
| Aumolertinib monotherapy | 44 | 65.9 % | 95.5 % |
| TP53 co-mutation | 21 | 71.4 % | 100 % |
| cell cycle co-mutation | 29 | 72.4 % | 100 % |
| PIK3CA co-mutation | 6 | 66.7 % | 100 % |
| PD-L1 expression | 21 | 71.4 % | 95.2 % |
| TPS 0-1 | 12 | 83.3 % | 91.7 % |
| TPS ≥ 1 | 9 | 55.6 % | 100 % |
| Combination therapy | 8 | 87.5 % | 100 % |
Conclusions
Aumolertinib monotherapy or combination therapy might be an appropriate therapeutic choice in EGFR-mutant NSCLC patients with co-mutations.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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