Abstract 1228P
Background
We present here the pooled data of Central Eastern Europe (CEE) patients (pts) included in REFLECT (NCT04031898) study. This multinational real-world study explored clinical characteristics, treatment patterns and survival outcomes in pts with non-small cell lung cancer (NSCLC) and EGFR mutations (EGFRm) receiving first-line (1L) EGFR tyrosine kinase inhibitors (TKIs) of first or second generation (1G/2G).
Methods
This was a physician-led chart review performed in 25 sites from 4 CEE countries (Bulgaria, Poland, Romania, Slovenia) and data were retrieved from 389 medical records. Pts initiating 1L 1G/2G EGFR TKIs between Jan 2016 - Jun 2018 were eligible. Data was collected from May to Dec 2019. Descriptive statistics and Kaplan-Meier methods for median progression free survival (mPFS) and overall survival (mOS) were used.
Results
Baseline characteristics: median age 68 yrs, 69% female, 51% never smokers, 82% ECOG 0-1, 52% exon 19 deletion, 34% L858R, 14% uncommon mutations and 20% pts with brain metastases. 1L EGFR TKIs included 37% erlotinib, 34% afatinib, 30% gefitinib. In total 320 (82%) pts discontinued 1L: 251 (65%) due to progression, 39 (10%) death and 30 (8%) other reasons; 298 (77%) progression events were registered, including per protocol start of a new line without progression. 1L mPFS was 14.0 months (mo; 95% CI 12.6, 15.6), mOS 28.4 (95% CI 25.8, 30.8) mo. Among pts with progression, 200 (67%) were tested for T790M with 58% positivity rate. Out of pts progressing, 197 (66%) started 2L therapy and 62 (21%) had no further treatment. 2L included mostly osimertinib (60%) and chemotherapy (36%). 2L was discontinued in 150 (76%) pts with 91 (46%) due to progression, 34 (17%) death and 25 (13%) other reasons. 3L was received by 62 (41%) pts discontinuing 2L, and 54 (47%) had no post-2L treatment. Only 123 (38%) pts discontinuing 1L received osimertinib in further lines.
Conclusions
REFLECT study provided a detailed real-world insight of treatment patterns and outcomes in pts with NSCLC receiving 1L 1G/2G EGFR TKIs in CEE region. Targeted therapies allow improved survival, but better use of new generation TKIs should be urged.
Clinical trial identification
NCT04031898.
Editorial acknowledgement
Editorial support was provided by Ana Maria Iordan (MedInteractiv) and was funded by AstraZeneca.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
A. Pluzanski: Financial Interests, Personal, Speaker’s Bureau: AstraZeneca; Financial Interests, Personal, Expert Testimony: AstraZeneca; Financial Interests, Personal, Other: AstraZeneca; Financial Interests, Personal, Speaker’s Bureau: Boehringer Ingelheim; Financial Interests, Personal, Expert Testimony: Boehringer Ingelheim; Financial Interests, Personal, Other: Boehringer Ingelheim; Financial Interests, Personal, Speaker’s Bureau: Pfizer; Financial Interests, Personal, Other: Pfizer; Financial Interests, Personal, Expert Testimony: Bristol Myers Squibb; Financial Interests, Personal, Other: Bristol Myers Squibb; Financial Interests, Personal, Advisory Role: MSD; Financial Interests, Personal, Other: MSD; Financial Interests, Personal, Other: Roche. B. Gafton: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Sandoz; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Accord Healthcare; Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Ipsen Pharma; Financial Interests, Personal, Invited Speaker: Novartis Pharma; Financial Interests, Personal, Invited Speaker: Amgen Romania; Financial Interests, Personal, Invited Speaker: Egis Pharmaceuticals; Financial Interests, Personal, Invited Speaker: Johnson & Johnson Romania; Financial Interests, Personal, Invited Speaker: Merck Sharp & Dohme Romania; Financial Interests, Personal, Invited Speaker: Angelini Pharmaceuticals; Financial Interests, Personal, Advisory Board: Sandoz; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Research Grant: Amgen GMBH; Financial Interests, Personal, Research Grant: PPD Global Limited. U. Janzic: Financial Interests, Personal, Other: AstraZeneca; Financial Interests, Personal, Other: Boehringer Ingelheim; Financial Interests, Personal, Other: MSD; Financial Interests, Personal, Other: Roche; Financial Interests, Personal, Other: Pfizer; Financial Interests, Institutional, Other: AstraZeneca; Financial Interests, Institutional, Other: Boehringer Ingelheim; Financial Interests, Institutional, Other: MSD; Financial Interests, Institutional, Other: Roche; Financial Interests, Institutional, Other: Pfizer; Financial Interests, Institutional, Other: Novartis; Financial Interests, Institutional, Other: Bristol Myers Squibb. D. Vidovic: Financial Interests, Personal, Other: AstraZeneca; Financial Interests, Personal, Other: Boehringer Ingelheim; Financial Interests, Personal, Other: Pfizer; Financial Interests, Personal, Other: Roche; Financial Interests, Personal, Other: Eli Lilly; Financial Interests, Personal, Other: Sapio; Financial Interests, Personal, Other: MSD; Financial Interests, Personal, Other: Novartis Pharma; Financial Interests, Personal, Other: Amgen Romania; Financial Interests, Personal, Other: GlaxoSmithKline; Financial Interests, Personal, Other: Chiesi; Financial Interests, Institutional, Other: Merck Sharp & Dohme Romania; Financial Interests, Institutional, Other: AstraZeneca; Financial Interests, Institutional, Other: Chiesi; Financial Interests, Institutional, Other: Pfizer; Financial Interests, Institutional, Other: Amgen GMBH; Financial Interests, Institutional, Other: Roche; Financial Interests, Institutional, Other: Boehringer Ingelheim; Financial Interests, Institutional, Other: Sapio; Financial Interests, Institutional, Other: Eli Lilly; Financial Interests, Institutional, Other: Novartis; Financial Interests, Institutional, Other: GlaxoSmithKline. R. Lupu: Financial Interests, Personal, Full or part-time Employment, employee: AstraZeneca. G. Teodorescu: Financial Interests, Personal, Full or part-time Employment, employee: AstraZeneca. T. Ciuleanu: Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Boehringer Ingelheim; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: Eli Lilly; Financial Interests, Personal, Advisory Role: Bristol Myers Squibb; Financial Interests, Personal, Advisory Role: MSD; Financial Interests, Personal, Advisory Role: Novartis Pharma; Financial Interests, Personal, Advisory Role: Amgen Romania; Financial Interests, Personal, Advisory Role: Astellas; Financial Interests, Personal, Advisory Role: Johnson & Johnson Romania; Financial Interests, Personal, Advisory Role: Merck Serono; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: Servier; Financial Interests, Personal, Advisory Role: AD pharma. All other authors have declared no conflicts of interest.