302P - Treatment patterns in resectable early-stage NSCLC in Taiwan: Subgroup analysis of a global real-world study

Background

Complete surgical resection is the recommended treatment for early-stage NSCLC, followed by adjuvant chemotherapy for patients (pts) with resectable stage II–IIIA and select stage IB disease; however, many pts will experience disease recurrence within five yrs post-surgery. Osimertinib, an EGFR-TKI, is approved as adjuvant therapy for pts with resected stage IB–IIIA EGFR-mutated (EGFRm) NSCLC based on results from the Phase III ADAURA trial. We conducted a global, non-interventional study in pts with resectable NSCLC and EGFR test results available to better understand RW EGFRm frequency, treatment practices and recurrence. Interim global results were previously published; here, we report final data from pts from Taiwan.

Methods

This retrospective medical record review included adults with completely resected stage IA–IIIA NSCLC diagnosed between Jan 1, 2014 and Dec 31, 2017 and with EGFR test results available. Pts were followed to Dec 31, 2020. Primary objectives included description of EGFRm frequency, treatment patterns (including surgical procedures) and recurrence.

Results

Of 200 pts enrolled in Taiwan, median age was 62 yrs (36–86 range) and 61% were female. 139 pts (70%) had EGFRm NSCLC and 61 (31%) EGFR wild-type (EGFRwt); IA/IB/IIA/IIB/IIIA disease stage at diagnosis was 31/37/13/3/17% vs 48/16/5/11/20%, respectively. The most common first surgical resection procedures were lobectomy (82% EGFRm vs 61% EGFRwt), wedge resection (19% vs 39%) and segmentectomy (8% vs 5%). Neoadjuvant treatment only was received by 5% EGFRm vs 2% EGFRwt and 43% vs 38% received adjuvant treatment only; chemotherapy was most common adjuvant treatment in both groups 55/60 (92%) vs 23/23 (100%), respectively. Among 43 pts (22%) with disease recurrence at any point following complete surgical resection, the most common sites of first recurrence were lung (42%), lymph nodes (23%) and brain (21%).

Conclusions

In this RW study of pts from Taiwan with surgically resected early-stage NSCLC who had an EGFR test result, 70% had EGFRm. The rates of EGFRm in this RW study reinforces the need for EGFR testing in early-stage NSCLC to identify pts who may benefit from EGFR-targeted therapy to help optimize clinical outcomes by reducing risk of recurrence.

Clinical trial identification

Editorial acknowledgement

The authors would like to acknowledge Gemma White, of Ashfield MedComms, Macclesfield, UK, an Inizio Company, for medical writing support that was funded by AstraZeneca in accordance with Good Publications Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

J. Shih: Financial Interests, Personal, Speaker’s Bureau: ACTgenomics, Amgen, Genconn Biotech, AstraZeneca, Roche, Bayer, Boehringer Ingelheim, Eli Lilly, Pfizer, Novartis, Merck Sharp & Dohme, Chugai Pharma, Takeda, CStone Pharmaceuticals, Janssen, TTY Biopharm, Orient EuroPharma, MundiPharma, Ono Pharmaceutical, Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Roche, Boehringer Ingelheim, Eli Lilly, Pfizer, Novartis, Merck Sharp & Dohme, Chugai Pharma, Ono Pharmaceutical, Takeda, CStone Pharmaceuticals, Janssen, Bristol Myers Squibb; Non-Financial Interests, Personal and Institutional, Research Grant: Roche; Non-Financial Interests, Personal and Institutional, Principal Investigator: Amgen, AstraZeneca, Roche, Novartis, Merck Sharp & Dohme, Janssen, Bristol Myers Squibb. S.H. Lin: Financial Interests, Personal, Research Grant: STCube Pharmaceuticals, Beyond Spring Pharmaceuticals, Nektar Therapeutics; Financial Interests, Personal, Advisory Board: Creatv Microtech, AstraZeneca; Financial Interests, Personal, Advisory Role: XRAD Therapeutics; Financial Interests, Personal, Stocks/Shares, Co-founder: Scenexo, Inc. S. Nagar: Financial Interests, Personal, Full or part-time Employment, Receiving consulting fee from AstraZeneca: RTI Health Solutions. K. Davis: Financial Interests, Personal, Funding: RTI Health Solutions; Other, Personal, Research Grant, Contract research funding: RTI Health Solutions. L. Servidio: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. L. Ho: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. R. Veluswamy: Financial Interests, Personal, Stocks/Shares: Clover Health; Financial Interests, Personal, Other, Honoraria: BMS, AstraZeneca, Merck, Novocure; Financial Interests, Personal, Advisory Role: BMS, AstraZeneca, Merck, Novocure, Beigene; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca (unbranded); Financial Interests, Personal, Research Grant: BMS, AstraZeneca. All other authors have declared no conflicts of interest.