491P - Furmonertinib as adjuvant therapy for elderly patients in resected EGFR-mutated non-small cell lung cancer: A double-center, real-world experience

Background

Furmonertinib (AST2818) is a novel, promising oral third-generation Epidermal Growth Factor Receptor (EGFR) tyrosine kinase inhibitor (TKI) that targets both EGFR sensitive mutations and T790M mutation, which has demonstrated efficacy in NSCLC in previous clinical trials. However, the efficacy and safety of furmonertinib as adjuvant therapy in patients ≥ 65 years old remain unclear.

Methods

Patients who underwent radical lung cancer surgery with EGFR mutations from two independent medical centers were enrolled and received furmonertinib 80mg daily. The adjuvant therapy time (6-36months) depended on patients’pathologic stage and physical conditions. The disease-free survival (DFS), safety and tolerability were evaluated.

Results

This study retrospectively analyzed 101 patients who were pathologically confirmed adenocarcinoma, EGFR mutation-positive (exon 19 deletion/L858R), stage IA2-IIIA NSCLC (60 females, 41 males, ranging in age from 43 to 86 years, with a median age of 65). Among them, 55 cases were ≥ 65 years old (median age 69 years, including 21 ≥ 70 years old), and 46 cases were<65 years old (median age 56.5 years old). All patients were followed at least 10 months, and 68 (67.3%) of them have been followed up for over 2 years, median follow-up time was 22 months. At data cutoff, all patients were alive, only 3 of them had metastasis (CNS, chest wall, and pancreas, respectively). The 2-year DFS rates for patients ≥ 65 years old and<65 years old were 96% and 97%, respectively (p=0.98). During therapy, 39 (38.6%) patients had treatment-related adverse events (TRAEs) of any grade. The most common TRAEs were rash (19/101, 18.8%), mouth ulcer (9/101, 8.9%) ，diarrhea (9/101, 8.9%) and transaminase elevation (5/101, 5.0%). Only 3 (3.0%) patients had TRAEs of grade 3 or higher and 1(1.4%) of them discontinued therapy. There was no significant difference in the incidence of TRAEs of any grade in patients aged ≥ 65 years and < 65 years (30.9% and 47.8%, p=0.08, respectively).

Conclusions

This is the first real-world study to demonstrate that furmonertinib has good efficacy and a tolerable safety profile in elderly patients (≥ 65 years) with completely resected stage I-III NSCLC harboring EGFR 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.