Abstract 151P
Background
Adjuvant osimertinib has demonstrated significant survival benefit for patients (pts) with stage IB-IIIA EGFR-mutated (EGFRm) non-small cell lung cancer (NSCLC). However, real-world data on adjuvant treatment patterns in stage I-III EGFRm NSCLC post-R0 resection remain limited.
Methods
The ADDRESS study (NCT04830826) was a prospective, multicenter, observational study. Eligible pts had stage I–III EGFRm NSCLC and underwent R0 resection were followed for two years. The primary endpoint was the initial adjuvant treatment pattern, the secondary endpoint was subsequent treatment patterns. All analyses were descriptive.
Results
Between July 2020 and June 2022, 1,490 pts with stage I-III EGFRm NSCLC were enrolled across 33 centers in China and evaluated for treatment pattern analysis. The median age at diagnosis was 59 years (range 23–86). Common, uncommon and unknown EGFR mutations were present in 85.0% (1,267/1,490) 9.9% (147/1,490), and 5.1% (76/1,490), respectively. Stages IA, IB, II, and III accounted for 77.9%, 10.9%, 4.9%, and 6.3%, with adjuvant therapy rates of 19.6%, 60.0%, 82.9%, and 82.2%, respectively. As of July 20, 2024, among 481 pts (32.3%) who received initial adjuvant therapy, 78.2% (376) received EGFR-TKI–based therapy, 7.7% (37) received chemotherapy alone, and 14.1% (68) received other treatments. Specifically, in stage IB-III pts, 71.4% (225/315) received adjuvant therapy, with 81.8% (184/225) undergoing EGFR-TKIs. Of these, 38.0% (70) received first-generation (1G) EGFR-TKIs and 61.4% (113) received third-generation (3G) EGFR-TKIs, predominantly osimertinib (48.9%, 90/184). The median treatment duration was 12.1 months for 3G EGFR-TKIs compared to 7.7 months for 1G EGFR-TKIs. Adverse events were the primary reason for discontinuation of EGFR-TKIs. The safety profile of adjuvant EGFR-TKI was consistent with previous reports.
Conclusions
This study supported adjuvant EGFR-TKIs as the standard of care for SIB-IIIA EGFRm NSCLC pts in clinical practices, however, further improvements of patient management are needed, given the lower adjuvant therapy rate in SIB pts and short treatment duration of EGFR-TKIs.
Legal entity responsible for the study
W. Liang.
Funding
AstraZeneca China.
Disclosure
All authors have declared no conflicts of interest.