Author of

• 20167

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  P2.03 - Chemotherapy/Targeted Therapy (ID 704)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Chemotherapy/Targeted Therapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23307

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    P2.03-036 - Comparing the Efficacy/Toxicity of Osimertinib and First Line EGFR-TKI by Individual Patient Analysis (ID 9380)

    09:30 - 09:30  |  Author(s): S. Murakami
    • Abstract

    Background:
    Osimertinib is a third generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), which showed its efficacy for T790M resistant mutation in patients with advanced and recurrent non small cell lung cancer (NSCLC). The efficacy and toxicity of osimertinib comparing to previous EGFR-TKIs are not fully elucidated. Since every patient receiving osimertinib has received previous EGFR-TKI therapy, we compared the efficacy and toxicity of those agents in the same patients.
    
    Method:
    We retrospectively reviewed medical records of patients with T790M mutation positive advanced and recurrent NSCLC, who had disease progression after previous EGFR-TKI, the standard first line therapy, and started osimertinib between April 2016 and March 2017 at National Caner Center Hospital. Progression free survival (PFS) of osimertinib, and 1st line EGFR-TKI PFS of the same patients were calculated by Kaplan-Meier method. Objective response rate (ORR) was assessed according to RECIST version 1,1. Adverse events (AEs) were also reviewed to evaluate the difference of safety profiles between osimertinib and previous EGFR-TKIs.
    
    Result:
    A total of 46 patients with T790M positive NSCLC received osimertinib after the failure of first line EGFR-TKI treatment. At May 2017, the median follow-up time since the start of osimertinib was 7.8months. The median age was 65 (range 36-82), the median number of treatment received before osimertinib was 3 (range 1-9), and the median wash out time of 1st line EGFR-TKI till the start of osimertinib was 14.0 months. The median PFS of osimertinib is not reached. The median PFS of first line EGFR-TKI was 15.2 months. ORR of osimertinib and first line EGFR-TKI was 56.0% and 65.2%, respectively. The most frequent AEs of any grade of osimertinib were rash, dry skin, paronychia, and diarrhea (39.4%, 35.8%, 32.1%, and 30.2%, respectively). Rash, paronychia, and diarrhea over grade 2 was 6.5%, 6.5%, and 0% with osimertinib, compared to 0%, 12.5%, and 4.1% with gefitinib, and 41.7%, 8.3%, and 0% with erlotinib. The incidence of pneumonitis with osimertinib treatment was 10.9% (5 cases) in any grade, and 6.5% (3 cases) in grade 3 to 4, though 2 of them (1 case in grade 1 and 1 in grade 3) had received nivolumab as the prior chemotherapy. Except for pneumonitis, there was no AE leading to permanent discontinuation related to osimertinib.
    
    Conclusion:
    Osimertinib showed the efficacy and feasibility even in practical use. Adverse effect of osimertinib was generally better tolerated than previous EGFR-TKIs, except for pneumonitis.