Abstract 937P
Background
There are few epidemiological and clinical data on non-small cell lung cancer (NSCLC) patients (pts) harboring EGFR mutations treated by surgery. The Adaura study has shown benefit of adjuvant treatment by osimertinib. The main objective of this study was to describe in a real-world setting the incidence, clinical and tumoral characteristics, mode of disease recurrence of EGFR-mutated NSCLC pts treated by surgery.
Methods
Main inclusion criteria were: consecutive pts with localized NSCLC treated by surgery between January 2018 and December 2019 in France. Following data were collected: demographic and clinical data, surgery type, staging, disease recurrence, therapeutic approach at disease recurrence. EGFR status was carried out retrospectively when not available in the medical chart.
Results
The analysis screened 1165 consecutive pts in 16 centers. EGFR status was retrospectively erformed in 699 cases (60%). The incidence of EGFR-mutated pts was 11.5% (n=134) with: age 69.5 (36-88) years, female 62%, never smokers 74%, adenocarcinoma 96%, PD-L 1 (TPS) status: 0%/1-49%/ ≥ 50%: 68%/24%/6%. The surgery was lobectomy, segmentectomy, wedge, pneumonectomy in 85%/10%/4%/ 1%, respectively, with complete lymph node dissection in 96% of cases by videothoracoscopy/ thoracotomy/ robot assist 43%/, 37%/ 13% of cases, respectively. Quality of resection was R0/R1 in 97% and 3% of case respectively. Staging post-surgery was: IA:47%, IB:16%, IIA:3.7%, IIB:11,2%, IIIA:19.4%, IIIB 0.03%. EGFR mutation exon was DEL19/ 21(L858R)/ 20/ 18/ others in 39.5%/ 39.5 %/12% /7%/ 1.5%; Adjuvant treatment was administrated in 28 (21%) patients (chemotherapy: 25 (92%), EGFR TKI 3 (8%). After a median follow up of 29.4 months, disease recurrence occurs in 29%(n=39) pts (n=8/n=3/n=3/n=8/n=17 in stage IA/ IB /IIA /IIB/IIIA) with metastatic progression 79% (n=31) of patients (brain, bone, pulmonary metastasis 26% /23%/ 23%, respectively) and local recurrence 46% (n=18). Disease-free survival (DFS) and treatment at progression will be presented at the meeting.
Conclusions
This real-world analysis provides incidence and outcomes of EGFR-mutated NSCLC treated by surgery, and identifies pts eligible to receive osimertinib adjuvant therapy according to the results of the Adaura trial.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
GFPC (Groupe Français de Pneumo-Cancérologie).
Funding
AstraZeneca.
Disclosure
J.B. Auliac: Financial Interests, Personal, Advisory Board: AstraZeneca, Boerhinger, BMS, Sanofi, Takeda, Amgen; Financial Interests, Personal, Invited Speaker: BMS, Sanofi, Amgen. P.A. Thomas: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca, EthiconEndosurgery. F. Guisier: Financial Interests, Personal, Advisory Board: BMS, AstraZeneca, MSD, Roche, Amgen; Financial Interests, Personal and Institutional, Invited Speaker: Pfizer, Takeda. O. Bylicki: Financial Interests, Personal, Expert Testimony: BMS, AstraZeneca, MSD, Roche; Non-Financial Interests, Institutional, Principal Investigator: AstraZeneca, MSD, Roche. A. Swalduz: Financial Interests, Personal, Advisory Board: BMS, AstraZeneca, Takeda, Roche, Lilly, Pfizer, Amgen, Janssen,; Financial Interests, Personal, Invited Speaker: BMS, AstraZeneca, Takeda, Roche, Boehringer, Pfizer, Amgen; Non-Financial Interests, Institutional, Principal Investigator: Roche, Takeda, Pfizer. M. Wislez: Financial Interests, Personal, Advisory Board: BMS, AstraZeneca, Takeda, Roche, Lilly, Pfizer, Amgen, Janssen; Financial Interests, Personal, Invited Speaker: BMS, AstraZeneca, Roche, Pfizer, Amgen; Non-Financial Interests, Institutional, Principal Investigator: Roche, Novartis, Lilly, MSD, Merck, AstraZeneca, Amgen. M. Geier: Financial Interests, Institutional, Research Grant: BMS, Roche; Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, Sanofi; Financial Interests, Personal, Invited Speaker: AstraZeneca. C. Decroisette: Financial Interests, Personal, Advisory Board: BMS, AstraZeneca, Novartis, Roche, Amgen, Pfizer, Sanofi, Janssen; Financial Interests, Institutional, Research Grant: Takeda, Pfizer. L. Falchero: Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Pfizer, BMS, MSD; Financial Interests, Personal, Speaker’s Bureau: Chiesi, Minarini; Financial Interests, Personal, Invited Speaker: Amgen. G. De Chabot: Financial Interests, Personal, Advisory Board: Takeda, MSD, BMS, Sanofi, AstraZeneca, Boehringer; Financial Interests, Personal, Invited Speaker: Roche. A. Lupo Mansuet: Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Pfizer; Financial Interests, Personal, Invited Speaker: AstraZeneca, Lilly, Amgen, Biocartis, MSD. C. Chouaid: Financial Interests, Personal, Advisory Board: AstraZeneca, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen; Financial Interests, Institutional, Funding: AstraZeneca, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen. L. Greillier: Financial Interests, Personal, Advisory Board: AbbVie, Astra Zeneca, BMS, MSD, Novartis, Sanofi, Takeda, Roche; Financial Interests, Personal, Invited Speaker: Lilly, Pfizer, Roche; Financial Interests, Institutional, Invited Speaker: AstraZeneca, AbbVie, BMS, MSD, Novartis, Sanofi, Takeda, Pfizer, PharmaMar. All other authors have declared no conflicts of interest.