Abstract 30P
Background
Advanced non-small cell lung cancer (aNSCLC) treatment (tx) decision-making is complex, with prognosis and tx influenced by molecular alterations. Data are limited on how epidermal growth factor receptor mutation (EGFRm) subtypes influence tx choice in clinical practice. We aimed to describe disease characteristics and tx patterns in aNSCLC patients (pts) with EGFRm.
Methods
Data were drawn from the Adelphi NSCLC Disease Specific Programme™, a point-in-time survey of oncologists/pulmonologists, collected in Brazil and Taiwan from Jul-Nov 2020. Physicians reported characteristic and tx data for the next 5 consulting adult aNSCLC pts with EGFRm, including pts with point-mutation in exon 21 (exon 21) and/or deletion in exon 19 (exon 19). Data analysis was descriptive.
Results
Of 471 pts, 26% (n = 124) had exon 21 and 35% (n = 167) had exon 19. Median age was 65.0 years, 57% were female and 87% had adenocarcinoma. At aNSCLC diagnosis, 77% were stage IV and 69% had an Eastern Cooperative Oncology Group performance status of 0–1. EGFR tyrosine kinase inhibitor (TKI) monotherapy (mono) was the most common first-line (1L) tx; 41% of pts received first generation (1G), 21% second generation (2G) and 16% third generation (3G) EGFR TKI regardless of mutation type. 26% of exon 21 and 27% of exon 19 pts received 2G EGFR TKI, while 9% and 21%, respectively, received 3G EGFR TKI. Of pts who completed 1L tx (n = 55), most (84%) had partial response regardless of mutation type (94% of exon 21, n = 15; 84% of exon 19, n = 21). Median time to discontinuation (TTD) of 1L was 14.2 months (mo) overall (n = 61); 17.1 mo in exon 21 (n = 16) and 16.0 mo in exon 19 (n = 27). Median time to next tx was 15.0 mo overall (n = 61); 19.0 mo in exon 21 (n = 15) and 17.0 mo in exon 19 (n = 27). Median real-world progression free survival (excluding death; rwPFS) was 15.1 mo overall (n = 61); 19.2 mo in exon 21 (n = 15) and 16.6 mo in exon 19 (n = 27).
Conclusions
Pts with EGFRm generally received EGFR TKI mono, including those with exon 21 and exon 19. Exon 21 pts had longer TTD and rwPFS (no formal comparison was made between groups). Future research should examine whether different sensitizing EGFR mutations have an impact on pt outcomes.
Legal entity responsible for the study
Adelphi Real World.
Funding
Adelphi Real World.
Disclosure
H. Bailey: Financial Interests, Institutional, Full or part-time Employment: Adelphi. H. Burlison: Financial Interests, Institutional, Full or part-time Employment: Adelphi. S. Chandrasekar: Financial Interests, Personal, Stocks/Shares: Pfizer; Financial Interests, Institutional, Full or part-time Employment: Pfizer. C.H. Wong: Financial Interests, Personal, Stocks/Shares: Pfizer; Financial Interests, Institutional, Full or part-time Employment: Pfizer. C. Forshaw: Financial Interests, Institutional, Full or part-time Employment: Adelphi. K. Duncan: Financial Interests, Personal, Stocks/Shares: Pfizer; Financial Interests, Institutional, Full or part-time Employment: Pfizer.