Abstract 152P
Background
There is an unmet need for patients (pts) with unresectable stage III EGFRm NSCLC who receive CRT. Consolidative immunotherapy has limited efficacy and no EGFR-TKIs are approved in this setting. We report interim data from a global, retrospective RW study of pts with unresectable stage III EGFRm NSCLC who received CRT.
Methods
Data were extracted from medical records of pts (≥18 years) with unresectable stage III EGFRm NSCLC diagnosed 1 Jan 2016–31 Dec 2019, who received CRT +/- durvalumab (durva) as standard of care (data cutoff: 31 Dec 2022). Study outcomes were: mutation testing and tx patterns, RW progression-free survival (rwPFS), time to next tx or death (rwTTNTD) and overall survival (rwOS).
Results
Pts (N=73) from South Korea (68%), US (25%), Japan (5%) and UK (1%) had a median age of 66 years; 56% were female, 91% had ECOG PS 0–1, 41% were current/former smokers, 92% had adenocarcinoma, 64% and 36% had EGFR Ex19del and L858R mutations, respectively. Tumour PD-L1 expression was negative (<1%), low (1–49%), high (≥50%) and unknown in 27%, 18%, 12% and 42% of pts, respectively. Overall, 85% received CRT alone and 15% received CRT + durva; 55% and 41% received concurrent or sequential CRT, respectively (4% unknown CRT sequence). CRT comprised platinum + paclitaxel (78%), platinum + pemetrexed (11%) and platinum/other + chemotherapy (11%). 78% of pts completed first tx, 12% discontinued due to adverse events, 16% discontinued for other reasons (of which 5% progressive disease). Of 60 pts (82%) who received a subsequent tx, 44 (73%) received EGFR-TKIs; 44 pts (60%) received a second subsequent tx (61% EGFR-TKIs). Median rwPFS, rwTTNTD and rwOS from CRT initiation were 9.0 months (95% confidence interval [CI] 6.1, 10.4), 10.7 months (95% CI 9.0, 14.1) and 60.9 months (95% CI 44.4, 66.9), respectively.
Conclusions
In this analysis of pts with unresectable stage III EGFRm NSCLC receiving CRT in RW clinical practice, the majority received EGFR-TKIs as subsequent tx following CRT. Despite relatively short rwPFS, rwOS was prolonged, which may be attributed to subsequent EGFR-TKI use.
Editorial acknowledgement
The authors would like to acknowledge Clare McCleverty, PhD, as contracted by Ashfield MedComms, an Inizio Company, for medical writing support that was funded by AstraZeneca.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
J. Neal: Financial Interests, Personal, Other, Honoraria: CME Matters, Clinical Care Options CME, Research to Practice CME, Medscape CME, Biomedical Learning Institute CME, MLI Peerview CME, Prime Oncology CME, Projects in Knowledge CME, Rockpointe CME, MJH Life Sciences CME, Medical Educator Consortium, HMP Education; Financial Interests, Personal, Advisory Role: AstraZeneca, Genentech/Roche, Exelixis, Takeda Pharmaceuticals, Eli Lilly and Company, Amgen, Iovance Biotherapeutics, Blueprint Pharmaceuticals, Regeneron Pharmaceuticals, Natera, Sanofi/Regeneron, D2G Oncology, Surface Oncology, Turning Point Therapeutics, Mirati Therapeutics, Gilead Sciences, AbbVie, Summit Therapeutics, Novartis, Novocure, Janssen Oncology, Anheart Therapeutics; Financial Interests, Institutional, Funding: Genentech/Roche, Merck, Novartis, Boehringer Ingelheim, Exelixis, Nektar Therapeutics, Takeda Pharmaceuticals, Adaptimmune, GSK, Janssen, AbbVie, Novocure; Financial Interests, Personal, Royalties: Up to Date - Royalties. J.B. Lee: Financial Interests, Personal, Invited Speaker: AstraZeneca, Guardant Health, Merck Sharp & Dohme, Roche, Takeda; Financial Interests, Personal, Research Grant: Yuhan Corp.; Financial Interests, Personal, Member: IASLC, AACR, ASCO, KSMO. M. Ahn: Financial Interests, Personal, Other, Speaker, consultant, advisor: Alpha Pharmaceutical, AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, Ono Pharmaceutical Co., Ltd., Roche, Takeda; Financial Interests, Personal, Other, Honoraria: AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, Ono Pharmaceutical Co., Ltd., Roche. R. Ariyasu: Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, Chugai Pharmaceutical, Bristol Myers Squibb. D. Smith: Financial Interests, Personal, Advisory Role, Paid for involvement on a panel discussion on durvalumab: AstraZeneca. S. Nagar: Financial Interests, Institutional, Full or part-time Employment: RTI Health Solutions; Financial Interests, Institutional, Other, Consulting fee: AstraZeneca. M. Jimenez: Financial Interests, Institutional, Other, Consulting fee: AstraZeneca. D.A. Kahangire: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. Y.J. Kim: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. F. Nasirova: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. S.H.H. Lin: Financial Interests, Personal, Full or part-time Employment: MD Anderson Cancer Center; Financial Interests, Personal, Stocks/Shares: Apple, Meta, Amazon, Tesla, Google; Financial Interests, Personal, Funding: STCube, Beyond Spring, Nektar Therapeutics; Financial Interests, Personal, Advisory Role: AstraZeneca, Creatv Microtech, XRAD Therapeutics. All other authors have declared no conflicts of interest.