1340P - Propensity score matching analysis for osimertinib versus comparator first-generation EGFR tyrosine kinase inhibitors as first-line treatment in patients with advanced EGFR-mutated non–small cell lung cancer: A Chinese, multicenter, real-world cohort study

Background

The phase 3 FLAURA trial compared osimertinib with either erlotinib or gefitinib in the first-line treatment of EGFR-mutant lung adenocarcinoma and showed longer PFS, OS and a similar safety profile. However, the efficacy and safety of osimertinib as a first-line treatment still need to be investigated in a real-world setting.

Methods

1556 patients with EGFR-mutated non–small cell lung cancer (NSCLC) who received osimertinib or a first-generation EGFR tyrosine kinase inhibitor (TKI) as first-line treatment were identified from the CAPTRA-Lung database. 1:2 propensity score matching (PSM) was used to adjust for clinical bias. Progression-free survival (PFS) and overall survival (OS) were compared using Kaplan-Meier analysis. Cox proportional hazards regression was used to identify factors associated with progression and survival.

Results

202 patients receiving osimertinib and 404 patients receiving first-line EGFR TKIs were enrolled. The objective response rate (ORR) was 63.4% vs. 48.0% (P<0.001) and the disease control rate (DCR) was 95.5% vs. 96.8% (P=0.443) in the osimertinib arm and the comparator arm separately. Median progression-free survival was 19.4 months (95% confidence interval [CI], 14.3 to 24.4) in the osimertinib arm and 10.9 months (95% CI, 9.3 to 12.5) in the comparator arm (hazard ratio for progression, 0.47; 95% CI, 0.38 to 0.59; P < 0.001). Median overall survival was 40.5 months (95% CI, 27.1 to 54.0) versus 34.3 months (95% CI, 30.6 to 38.0) in the osimertinib and comparator groups, respectively (hazard ratio for death, 0.76; 95% CI, 0.58 to 1.00; P = 0.045). Most adverse events were mild and there were no treatment-related deaths. Patients treated with osimertinib showed a similar safety profile to the comparator EGFR TKIs.

Conclusions

In the real-world setting, osimertinib also demonstrated longer PFS, OS and a similar safety profile to comparator EGFR TKIs when given as first-line treatment to NSCLC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

National High Level Hospital Clinical Research Funding.

Disclosure

All authors have declared no conflicts of interest.