1524 - Effectiveness of sequencing TKIs in patients with EGFR mutation-positive Non-small-Cell Lung Cancer (NSCLC): A French National medico administrative claim database analysis

Background

Treatment of EGFR mutation-positive NSCLC has been revolutionized with the development of EGFR tyrosine kinase inhibitors (TKIs). Three generations of TKIs are now available (1st: erlotinib, gefitinib; 2nd: afatinib, dacomitinib; 3rd: osimertinib). Osimertinib has been developed as second-line treatment after a first-line TKI 1G or 2G when patients progressed with T790M-positive tumors, the most frequent mechanism of resistance. While osimertinib may also be given as first-line treatment, limited data exists on the real life effectiveness of the TKIs sequencing approach: TKI 1G or 2G followed by osimertinib. The French National medico administrative claim database (SNDS) offers the opportunity to estimate the effectiveness parameters for these patients in France.

Methods

Based on SNDS, a historic cohort of patients with a diagnosis of EGFR-mutated NSCLC treated, after a first-line with a TKI 1G or 2G, with osimertinib in second-line between 2015 and 2017 was extracted. Follow-up was conducted until December 31st 2017. Patients’ characteristics, Time on treatments and Overall survival were analysed.

Results

1,404 NSCLC patients have been treated with osimertinib in the database between 2015 and 2017. Among them, 509 had a previous treatment with TKI 1G or 2G without any other anticancer drug before osimertinib initiation, and constitute the analysed population. Mean age was 70.9 (29.1% were above 80 years old), 25.7% were males. Median time on TKI treatment (between the beginning of the first TKI 1G or 2G until discontinuation of osimertinib) was not reached but the percentages of patients still treated were: 83.8% at 24 months and 75.5% at 36 months. Median overall survival was not reached but the percentages of patients still alive were: 79.6% at 24 months and 70.3% at 36 months. Updated data will be presented at the meeting.

Conclusions

Our cohort confirms the prolonged time on TKI treatment and survival rates of patients receiving TKI 1G or 2G followed by osimertinib in a real life setting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Boehringer Ingelheim.

Disclosure

N. Girard: Honoraria (self): AstraZeneca; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): GlaxoSmithKline; Honoraria (self): Hoffmann La Roche; Honoraria (self): Lilly; Honoraria (self): Merck Sharp Dohme; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Takeda. S. Bouee: Full / Part-time employment: CEMKA. D. Moro-Sibilot: Honoraria (self), Honoraria (institution): AstraZeneca; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Honoraria (institution): Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self), Honoraria (institution): Roche; Honoraria (self), Advisory / Consultancy: Takeda; Honoraria (self), Advisory / Consultancy: AbbVie. C. Emery: Full / Part-time employment, CEMKA received a grant from Boehringer Ingelheim to perform the statistical analysis of this study : CEMKA. K. Le Lay: Full / Part-time employment: Boehringer Ingelheim. L. Luciani: Full / Part-time employment: Boehringer Ingelheim. C. Maritaz: Full / Part-time employment: 4. Boehringer Ingelheim. C. Chouaid: Honoraria (self): AstraZeneca; Honoraria (self): Boehringer Ingelheim; Honoraria (self): GlaxoSmithKline; Honoraria (self): Roche; Honoraria (self): Sanofi; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Lilly; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Takeda; Honoraria (self): Bayer; Honoraria (self): Amgen.