Abstract 60P
Background
Finnish hospital data lakes enable unique opportunity for real-world evidence studies by integrating hospital electronic health records with national registers. This study utilizes these data to characterize EGFR-mutated NSCLC patients’ demographics, clinical characteristics, treatment paths, and outcomes in Finland.
Methods
This retrospective observational study analyzed hospital data lakes and national registry data for EGFR-positive NSCLC patients from two Finnish university hospitals (2017–2023), representing ~55% of diagnosed cases in Finland. It assessed EGFR mutation incidence, demographic and clinical characteristics at diagnosis, and treatment paths for early and advanced-stage disease using Kaplan-Meier and Cox regression analyses.
Results
A total of 544 patients were included in the study (mean age 70.6 ± 10.1 years; 68% women; 51% with stage IV disease, 19% with other cancers). The incidence of EGFR mutations in NSCLC was 8% (all histology types). The most common EGFR mutations were exon 19 deletions (Del19) (40.4%), L858R (33.0%), and exon 20 insertions (ex20ins) (5.5%). In advanced stage, third-generation TKI was the most common treatment (37% during the whole study period), and for early stages, surgery was most frequent therapy (63%). Median time to next treatment (TTNT) was 50 months for early-stage patients and 13 months for advanced stage. TTNT results in early stage and advanced stage disease by mutational status were 53 and 18 months for Del19, 39 and 13 months for L858R, and 52 and 7 months for ex20ins, respectively. Median overall survival (OS) for advanced stage patients was 23 months. The OS for advanced stage patients with Del19 mutations was 37 months, for L858R 21 months, and for ex20ins 16 months. Five-year survival for early-stage patients overall was 70%, and for patients with Del19 mutations 77%, L858R 56%, and ex20ins 88%.
Conclusions
This Finnish retrospective multicenter study demonstrated survival differences based on EGFR mutations, underscoring the need to improve therapeutic strategies, particularly for ex20ins mutations.
Legal entity responsible for the study
M. Silvoniemi.
Funding
Johnson & Johnson.
Disclosure
L. Nurmi: Financial Interests, Institutional, Full or part-time Employment, Lalli Nurmi received consulting fees paid to their employer by Johnson & Johnson: Nordic Healthcare Group Oy. M. Ekblom: Financial Interests, Institutional, Full or part-time Employment, Monica Ekblom is a employee of Johnson & Johnson: Johnson & Johnson. A. Bonin: Financial Interests, Institutional, Full or part-time Employment, Anna Bonin is a employee of Johnson & Johnson: Johnson & Johnson. E.K. Heikkila: Financial Interests, Institutional, Full or part-time Employment, Eija Heikkila received consulting fees paid to their employer by Johnson & Johnson: Nordic Healthcare Group Oy. All other authors have declared no conflicts of interest.