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Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors.
Target Oncol. 2018 08; 13(4):501-507.TO

Abstract

BACKGROUND

The prognosis of patients with non-small cell lung cancer (NSCLC) who develop leptomeningeal metastasis (LM) is poor.

OBJECTIVE

To assess the clinical efficacy of osimertinib, a third-generation tyrosine-kinase inhibitor (TKI), in patients with epidermal growth-factor receptor (EGFR)-mutated NSCLCs and LM.

PATIENTS AND METHODS

Retrospective study of NSCLC patients with osimertinib-treated EGFR-mutated NSCLC and LM.

RESULTS

Twenty patients (mean age, 61.2 years; 70% women) with adenocarcinoma NSCLC were included in the study. EGFR mutations were reported in exons 18 (n = 2), 19 (n = 7), and 21 (n = 11). Before starting osimertinib, patients had received a mean of 2.3 treatment lines. When LM was diagnosed, all patients had clinical symptoms. Sixteen (80%) patients had a performance status ≥2. At osimertinib initiation, 13 (65%) patients harbored the EGFR-T790M-resistance mutation. Osimertinib was started at 80 (n = 17), 160 (n = 2), or 40 mg/day (n = 1). All 13 (100%) patients with the T790M mutation and 4 (57%) of those without it obtained clinical responses. Among the 11 radiologically assessable patients, 9 (82%) responded, with 5 responses reported within 15 days after treatment initiation. Median overall survival and progression-free survival were 18.0 and 17.2 months, respectively, from the start of osimertinib.

CONCLUSIONS

In this non-selected population, osimertinib had remarkable efficacy in NSCLC patients with LM irrespective of the presence of the EGFR-T790M-resistance mutation. Osimertinib efficacy was rapid in several patients, even some with poor performance status.

Authors+Show Affiliations

Pneumologie et Oncologie Thoracique, CH François-Quesnay, 2, Boulevard de Sully, 78200, Mantes-la-Jolie, France.Pneumologie et Oncologie Thoracique, CH François-Quesnay, 2, Boulevard de Sully, 78200, Mantes-la-Jolie, France. j-b.auliac@ch-mantes-la-jolie.fr.Oncologie, Centre Léon-Bérard, Lyon, France.Pneumologie et Oncologie Thoracique, CHU d'Amiens, Amiens, France.Pneumologie, CHU Clermont-Ferrand, Clermont-Ferrand, France.Pneumologie, CHU Vendée, La Roche-sur-Yon, France.Oncologie, Centre François-Baclesse, Caen, France.Pneumologie, CH François-Mitterrand, Pau, France.Pneumologie, CHU Charles-Nicolle, Rouen, France.Pneumologie, Hôpital Nord-Ouest, Villefranche-sur-Saône, France.Oncologie, Centre François-Baclesse, Caen, France.Pneumologie, CH Intercommunal de Créteil, Créteil, France.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30039345

Citation

Saboundji, Karima, et al. "Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer With Leptomeningeal Metastases Pretreated With EGFR-Tyrosine Kinase Inhibitors." Targeted Oncology, vol. 13, no. 4, 2018, pp. 501-507.
Saboundji K, Auliac JB, Pérol M, et al. Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors. Target Oncol. 2018;13(4):501-507.
Saboundji, K., Auliac, J. B., Pérol, M., François, G., Janicot, H., Marcq, M., Dubos-Arvis, C., Renault, A., Guisier, F., Odier, L., Gervais, R., & Chouaïd, C. (2018). Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors. Targeted Oncology, 13(4), 501-507. https://doi.org/10.1007/s11523-018-0581-2
Saboundji K, et al. Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer With Leptomeningeal Metastases Pretreated With EGFR-Tyrosine Kinase Inhibitors. Target Oncol. 2018;13(4):501-507. PubMed PMID: 30039345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors. AU - Saboundji,Karima, AU - Auliac,Jean-Bernard, AU - Pérol,Maurice, AU - François,Géraldine, AU - Janicot,Henri, AU - Marcq,Marie, AU - Dubos-Arvis,Catherine, AU - Renault,Aldo, AU - Guisier,Florian, AU - Odier,Luc, AU - Gervais,Radj, AU - Chouaïd,Christos, PY - 2018/7/25/pubmed PY - 2019/9/19/medline PY - 2018/7/25/entrez SP - 501 EP - 507 JF - Targeted oncology JO - Target Oncol VL - 13 IS - 4 N2 - BACKGROUND: The prognosis of patients with non-small cell lung cancer (NSCLC) who develop leptomeningeal metastasis (LM) is poor. OBJECTIVE: To assess the clinical efficacy of osimertinib, a third-generation tyrosine-kinase inhibitor (TKI), in patients with epidermal growth-factor receptor (EGFR)-mutated NSCLCs and LM. PATIENTS AND METHODS: Retrospective study of NSCLC patients with osimertinib-treated EGFR-mutated NSCLC and LM. RESULTS: Twenty patients (mean age, 61.2 years; 70% women) with adenocarcinoma NSCLC were included in the study. EGFR mutations were reported in exons 18 (n = 2), 19 (n = 7), and 21 (n = 11). Before starting osimertinib, patients had received a mean of 2.3 treatment lines. When LM was diagnosed, all patients had clinical symptoms. Sixteen (80%) patients had a performance status ≥2. At osimertinib initiation, 13 (65%) patients harbored the EGFR-T790M-resistance mutation. Osimertinib was started at 80 (n = 17), 160 (n = 2), or 40 mg/day (n = 1). All 13 (100%) patients with the T790M mutation and 4 (57%) of those without it obtained clinical responses. Among the 11 radiologically assessable patients, 9 (82%) responded, with 5 responses reported within 15 days after treatment initiation. Median overall survival and progression-free survival were 18.0 and 17.2 months, respectively, from the start of osimertinib. CONCLUSIONS: In this non-selected population, osimertinib had remarkable efficacy in NSCLC patients with LM irrespective of the presence of the EGFR-T790M-resistance mutation. Osimertinib efficacy was rapid in several patients, even some with poor performance status. SN - 1776-260X UR - https://www.unboundmedicine.com/medline/citation/30039345/Efficacy_of_Osimertinib_in_EGFR_Mutated_Non_Small_Cell_Lung_Cancer_with_Leptomeningeal_Metastases_Pretreated_with_EGFR_Tyrosine_Kinase_Inhibitors_ L2 - https://dx.doi.org/10.1007/s11523-018-0581-2 DB - PRIME DP - Unbound Medicine ER -