Abstract 1363P
Background
Treatment of patients with locally advanced/metastatic (LA/M) EGFR mutated (EGFRm) non-small cell lung cancer (NSCLC) continues to evolve and is not well characterised in Belgium. We aimed to investigate the treatment patterns in first and further lines, with special focus on treatment after progression on a first or second generation (1G/2G) EGFR-tyrosine kinase inhibitor (TKI).
Methods
In this retrospective Belgian study (REVEAL), patients diagnosed with LA/M EGFRm NSCLC between 1 Sep 2015 and 31 Dec 2017 were investigated for demographics, disease characteristics, treatment patterns, patient outcomes and EGFR mutation testing at diagnosis and at progression after a first 1G/2G EGFR-TKI. Patients were observed until 1 Sep 2018 or end of clinical activity/death. Here we describe the demographics, treatment patterns and T790M testing.
Results
141 patients were enrolled (median age of 69 years; 63% female; 95% Caucasian; 89% metastatic disease; 77% were ECOG 0/1 at diagnosis). 96% (135/141) received a first line systemic treatment (74% 1G/2G EGFR-TKI, 18% chemotherapy, 2% immunotherapy, 2% other). 52% (73/141) of patients received a systemic 2L therapy and 23% (32/141) a 3L. At the end of the study, 57% (80/141) had discontinued all therapy and 43% (61/141) had ongoing treatment. 11% of all enrolled patients (16/141) received their first EGFR-TKI in the 2L only. From all patients who progressed on and discontinued their first 1G/2G EGFR-TKI either in 1/2/3L, 74% (45/61) received a subsequent treatment (78% (36/46) after 1L; 57% (8/14) after 2L; 100% (1/1) after 3L). From the patients who progressed on a first 1G/2G EGFR-TKI, 72% (47/65) had a T790M test performed and 53% of them (25/47) were positive for T790M. In total 30% (20/66) of the patients who progressed on a first 1G/2G EGFR-TKI were treated with osimertinib in the 2L or 3L.
Conclusions
These real-life Belgian data reveal that 26% of LA/M EGFRm NSCLC patients who progress on and discontinue a first 1G/2G EGFR-TKI do not receive a subsequent treatment. In addition, only 30% of patients receive osimertinib in a 2L or 3L upon progression. These findings are in line with other recently published international real-word data.
Clinical trial identification
D5161R00007; NCT03761901.
Editorial acknowledgement
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
K. Cuppens: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Honoraria (self), Travel/Accommodation/Expenses: Bristol-Myers-Squibb; Honoraria (self), Travel/Accommodation/Expenses: Hoffman-La Roche; Honoraria (self), Travel/Accommodation/Expenses: Merck-Sharp-Dohme; Honoraria (self), Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self): Merck-Serono. L. Lodewyckx: Full/Part-time employment: AstraZeneca. I. Demedts: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): AstraZeneca. L. Decoster: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Travel/Accommodation/Expenses: Hoffman-La Roche; Travel/Accommodation/Expenses: Merck-Sharp-Dohme; Research grant/Funding (institution): Boehringer Ingelheim. B. Colinet: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Honoraria (self), Travel/Accommodation/Expenses: Bristol-Myers-Squibb; Honoraria (self), Travel/Accommodation/Expenses: Hoffman-La Roche; Honoraria (self), Travel/Accommodation/Expenses: Merck-Sharp-Dohme; Honoraria (self), Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self), Travel/Accommodation/Expenses: Bayer. K. Deschepper: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Honoraria (self): Hoffman-La Roche; Honoraria (self): Merck-Sharp-Dohme; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Bristol-Myers-Squibb. A. Janssens: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Travel/Accommodation/Expenses: Hoffman-La Roche. D. Galdermans: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca; Honoraria (self): Hoffman-La Roche; Honoraria (self): Merck-Sharp-Dohme; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Chiesi. T. Pieters: Honoraria (self), Honoraria (institution), Advisory/Consultancy: AstraZeneca.