Abstract 615P
Background
In LAURA (NCT03521154), osimertinib after definitive CRT demonstrated statistically significant and clinically meaningful progression-free survival (PFS) benefit in pts with UR stg III EGFRm NSCLC (PFS HR [95% CI], 0.16 [0.10, 0.24]; p<0.001). It is important to understand rw Tx patterns/clinical outcomes in this setting to measure the impact of new Txs. We report final results from a global, retrospective, rw study in pts with UR stg III EGFRm NSCLC who received CRT as SoC.
Methods
Data were extracted from records of adult pts with UR stg III EGFRm (Ex19del/L858R) NSCLC diagnosed Jan 2016–Dec 2019 who received CRT as SoC. Primary endpoint: rwPFS. Secondary endpoints: mutation testing and Tx patterns, rw time to next Tx or death (rwTTNTD), rw overall survival (rwOS). DCO: 31 Dec 2022.
Results
Overall, 172 pts from South Korea (30%), Japan (30%), USA (20%), Taiwan (15%), UK (5%) and Austria (1%) with UR stg III EGFRm (Ex19del, 59%/L858R, 41%) NSCLC were enrolled; median age, 67 yrs; ECOG PS 0/1, 91%; current/former smokers, 37%. Overall, 130 (76%) and 42 (24%) pts received concurrent or sequential CRT, respectively. The most common chemotherapy regimen was carboplatin + paclitaxel (45/172; 26%). In total, 134 (78%), 31 (18%) and 6 (3%) patients, respectively, received CRT alone, CRT + durvalumab and CRT + EGFR-TKI as first Tx; EGFR-TKIs were the most common first subsequent Tx (86/115; 75%). In pts who received CRT alone, median (95% CI) rwPFS, rwTTNTD and rwOS were 6.7 (6.0, 9.0), 11.4 (9.0, 14.4) and 66.9 (56.9, NE) months, respectively (Table).
Conclusions
In this global rw analysis of pts with UR stg III EGFRm NSCLC, most pts received CRT alone as first Tx; most common subsequent Tx was EGFR-TKIs. In pts who received CRT alone, rwPFS was consistent with prior studies; rwOS was substantial despite relatively short rwPFS, which may be attributable to subsequent EGFR-TKIs. Table: 615P
| All pts (N=172) | |
| First Tx, n (%) | 172 (100) |
| CRT alone | 134 (78) |
| CRT + durvalumab* | 31 (18) |
| CRT + EGFR-TKI | 6 (3) |
| First subsequent Tx, n (%) | 115 (67) |
| EGFR-TKI | 86 (75) |
| Chemotherapy | 15 (13) |
| Radiotherapy | 11 (10) |
| Immunotherapy† | 3 (3) |
| Clinical outcomes, median months (95% CI) | |
| CRT alone, n | 134 |
| rwPFS | 6.7 (6.0, 9.0) |
| rwTTNTD | 11.4 (9.0, 14.4) |
| rwOS | 66.9 (56.9, NE) |
| CRT + durvalumab, n | 31 |
| rwPFS | 11.9 (9.1, 24.0) |
| rwTTNTD | 25.4 (12.9, NE) |
| rwOS | 52.8 (48.9, NE) |
*In addition, one patient received CRT + pembrolizumab. †One patient received immunotherapy + chemotherapy.
Clinical trial identification
Editorial acknowledgement
The authors would like to acknowledge Fiona Neylon, BSc of Ashfield MedComms, an Inizio Company, for medical writing support.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
M. Ahn: Financial Interests, Personal, Advisory Role: AstraZeneca, Roche, MSD, Merck, TAKEDA, ONO, Novartis, Lilly, Amgen, YUHAN, Alpha Pharmaceuticals; Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche, MSD, Merck, TAKEDA, ONO, Novartis, Lilly, Amgen, YUHAN. S.H. Lin: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Role: XRAD Therapeutics, SEEK Diagnsotics; Financial Interests, Personal, Full or part-time Employment: MD Anderson; Financial Interests, Personal, Funding: Beyond Spring Pharmaceuticals, Nektar Therapeutics, STCube; Financial Interests, Personal, Ownership Interest: SEEK Diagnostics; Financial Interests, Personal, Stocks/Shares: SEEK Diagnostics. C. Yang: Financial Interests, Personal, Advisory Board: AstraZeneca, BI, Pfizer, Ono, MSD, Lilly, Roche, Novartis; Financial Interests, Personal, Invited Speaker: AstraZeneca, BI, Ono, MSD, Pfizer, Lilly, Roche; Financial Interests, Personal, Local PI: AstraZeneca, BI, Pfizer; Financial Interests, Personal, Speaker, Consultant, Advisor: AstraZeneca, BI, Pfizer, Ono, MSD, Lilly, Roche, Novartis. J. Neal: Financial Interests, Personal, Advisory Board: AstraZeneca, Genentech/Roche, Exelixis, Takeda Pharmaceuticals, Eli Lilly and Company, Amgen, Iovance Biotherapeutics, Blueprint Pharmaceuticals, Regeneron Pharmaceuticals, Natera, Sanofi/Regeneron, D2G Oncology, Surface Oncology, Turning Point Therapeutics, Mirati Therapeutics, Gilead Sciences, AbbVie, Summit Therapeutics, Novartis, Novocure, Janssen Oncology, Anheart Therapeutics; Financial Interests, Institutional, Funding: Genentech/Roche, Merck, Novartis, Boehringer Ingelheim, Exelixis, Nektar Therapeutics, Takeda Pharmaceuticals, Adaptimmune, GSK, Janssen, AbbVie, Novocure; Other, Personal, Other, Honoraria: CME Matters, Clinical Care Options CME, Research to Practice CME, Medscape CME, Biomedical Learning Institute CME, MLI Peerview CME, Prime Oncology CME, Projects in Knowledge CME, Rockpointe CME, MJH Life Sciences CME, Medical Educator Consortium, HMP Education. K. Okishio: Financial Interests, Personal, Speaker, Consultant, Advisor: Bristol Myers Squibb K.K., AstraZeneca K.K., Chugai Pharmaceutical Co. Ltd, Nippon Kayaku Co. Ltd, Takeda Pharmaceutical Company Limited, Taiho Pharmaceutical Co. Ltd, Sawai Pharmaceutical Co. Ltd. K. Nishino: Financial Interests, Personal, Advisory Board: Pfizer, Janssen Pharmaceutical K.K., AstraZeneca; Financial Interests, Personal, Coordinating PI: Ono Pharmaceutical Co. LTD., TAIHO Pharmaceutical Co. LTD., MSD, AbbVie, Daiichi Sankyo Company Ltd., Amgen, Eli Lilly, Eisai Co. Ltd., Sanofi K.K., Janssen Pharmaceutical K.K., Novartis, Pfizer, Merck Biopharma Co. Ltc., Takeda Pharmaceutical Co. Ltd, Ch; Financial Interests, Personal, Invited Speaker: Ono Pharmaceutical Co. LTD., MSD, Amgen, Janssen Pharmaceutical K.K., Novartis, Pfizer, Eli Lilly Japan, Merck Biopharma Xo. Ltd., Takeda, Chugai, AstraZeneca, Nippon Boehringer Ingelheim, Daiichi Sankyo, Mochida, Yuyu Teijn Medicare Inc. Varian Medical S. D. Smith: Financial Interests, Personal, Speaker, Consultant, Advisor: AstraZeneca. M. Jimenez: Financial Interests, Institutional, Speaker, Consultant, Advisor, RTI Solutions received consulting fees from AstraZeneca: AstraZeneca. S.P. Nagar: Financial Interests, Personal, Other, Consulting services to AstraZeneca: AstraZeneca. F. Nasirova, Y.J. Kim: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. All other authors have declared no conflicts of interest.