473P - Treatment (tx) patterns in resectable stage IA–IIIA non-small cell lung cancer (NSCLC) in China: Subgroup analysis of a global real-world (rw) study

Background

Surgical resection (R) ± adjuvant (adj) chemotherapy (CT) is recommended for patients (pts) with stage II–IIIA NSCLC and select pts with stage IB NSCLC, however, 5-yr overall survival rates are suboptimal. ADAURA showed a survival benefit with adj osimertinib after surgery ± adj CT in pts with resected stage IB–IIIA EGFR-mutation positive (EGFRm) NSCLC; this tx is now standard of care in this setting. EGFRm NSCLC is prevalent in China; we report the proportion of pts with EGFRm NSCLC, pt demographics and tx patterns from a Chinese cohort of a global retrospective rw study prior to adj osimertinib approval.

Methods

The study population included pts ≥18 yr old, with stage IA–IIIA NSCLC who had a test for EGFR mutations (EGFRmut) and were diagnosed 01 Jan 2015–31 Dec 2020. Primary objective assessed in these pts: proportion of EGFRm NSCLC. Pts diagnosed 01 Jan 2015–31 Dec 2017, who had complete surgical R, were assessed for pt characteristics and tx patterns (primary objectives) and sites of recurrence (secondary objective) from diagnosis until 31 Dec 2020 or last follow-up/death.

Results

Of 4,636 pts, 2,248 (48%) had EGFRm NSCLC, of whom 83% had common EGFRmut; proportion of common EGFRmut did not differ by age/NSCLC stage. Proportion of EGFRm NSCLC was similar in a subgroup of 300 pts who had R (149 [50%], 85% common EGFRmut). In pts who had R, mean age was 58 yr (range 31–81), 50% were female, 65% never smokers; open lobectomy (53%) and video-assisted thoracoscopic surgery (29%) were the most common first R procedures; 56% of pts did not receive systemic tx (Table). In pts who had R, 121 (40%) had recurrence, of whom 83% had distant recurrence; most common sites of recurrence: lung (45%), bone (17%), brain (13%) and pleura (10%). Table: 473P

*No patients received neoadjuvant treatment only

Conclusions

Around half of Chinese pts with stage IA–IIIA NSCLC in this study had EGFRm NSCLC. Of pts who had R, the majority did not receive systemic tx; these data highlight the need for early-stage EGFR testing to optimise tx choice.

Clinical trial identification

Editorial acknowledgement

Medical writing support for the development of this abstract, under the direction of the authors, was provided by Alice Walter, BSc, of Ashfield MedComms, an Inizio company, and was funded by AstraZeneca in accordance with Good Publications Practice (GPP) guidelines (http://www.ismpp.org/gpp-2022).

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

H. Wang: Non-Financial Interests, Personal, Local PI: AstraZeneca. S. Lu: Financial Interests, Personal, Research Funding: AstraZeneca, Hutchison, BMS, Heng Rui, BeiGene, Roche, Hansoh, Lilly Suzhou Pharmaceutical Co.Ltd; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, Roche, Hansoh; Financial Interests, Personal, Advisory Board: Hengrui Therapeutics; Financial Interests, Personal, Advisory Role: AstraZeneca, Pfizer, Boehringer Ingelheim, Hutchison MediPharma, ZaiLab, GenomiCare, Yuhan Corporation, Menarini, InventisBio Co. Ltd., Shanghai Fosun Pharmaceutical (Group) Co., Ltd., Simcere Zaiming Pharmaceutical Co., Ltd., Roche. Y. Li: Non-Financial Interests, Personal, Local PI: AstraZeneca. G. Hu: Non-Financial Interests, Personal, Local PI: AstraZeneca. Q. Wang: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks or ownership: AstraZeneca. S. Tan: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. M. Sandelin: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks or ownership: AstraZeneca. D. Kahangire: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. All other authors have declared no conflicts of interest.