Author of

• 18374

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  P3.02b - Poster Session with Presenters Present (ID 494)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18442

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    P3.02b-068 - Outcomes of Patients with Advanced EGFR Mutation Positive Adenocarcinoma of Lung Treated with Gefitinib in Northern Ireland 2010-2016 (ID 5328)

    14:30 - 14:30  |  Author(s): M. Devlin
    • Abstract

    Background:
    First-line treatment with tyrosine kinase inhibitors (TKIs) improves overall response rates (RR) and progression free survival (PFS) within trial populations with advanced adenocarcinoma of the lung harbouring gain of function EGFR mutations, when compared to platinum based doublet chemotherapy. Moreover, TKI therapy is associated with improvement in quality of life and better toxicity profile. Gefitinib was the first such drug to be approved by NICE for this purpose. We aimed to investigate the outcomes of Gefitinib therapy in a non-trial population.
    
    Methods:
    Patients diagnosed with metastatic lung adenocarcinoma, with an EGFR activating mutation and subsequently treated with Gefitinib in Northern Ireland between 2010 and 2016 were identified by means of an electronic database. The Adult Comorbidity Evaluation scale (ACE-27) determined overall co-morbidity scores.
    
    Results:
    Thirty patients received gefitinib for this indication. The majority were female (n= 19, 63%), Caucasian (n=27, 90%) and never smokers (n=13, 54%). Mean age at diagnosis was 63 (43-86) and all were performance status (PS) ≤2. Exon 19 deletion and L848R accounted for 65.5% of mutations. 26 patients were evaluable for response. 3 died prior to CT assessment. Disease control rate was 69% (42% partial response + 30.7% stable disease). Grade 3/ 4 toxicity included rash (3.3%) and hepatotoxicity (13%). Median PFS was 211 days (55-684) and OS was 441 days (61-1428). An ACE-27 score>1 was associated with significantly poorer PFS (57 vs 246d, p=0.0007) and OS (91 vs 549d, p=0.0017), as was PS 2. Compared to other EGFR mutations, patients harbouring L858R also had inferior survival rates (PFS: 130 vs 260 d, p=0.006, OS: 312 vs 563d, p=0.0031).Figure 1
    
    
    
    Conclusion:
    Gefitinib was well tolerated; however RR and PFS were lower than those reported in clinical trial, possibly reflecting our small, unselected population. High ACE-27 score, PS2 and L858R mutation were significantly associated with inferior survival.