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Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer.
Target Oncol. 2019 06; 14(3):307-314.TO

Abstract

BACKGROUND

The resistance mutation T790M is reported in 50-60% of patients pretreated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Osimertinib has been approved in these patients, but data in octogenarians remain rare.

OBJECTIVE

The objective of this retrospective analysis was to evaluate in real life the efficacy of osimertinib in a population of octogenarian patients.

METHODS

This retrospective multicentric study included pretreated octogenarian patients with EGFR T790M-mutated advanced non-small cell lung cancer (NSCLC) in the setting of the French early access program for osimertinib. The primary endpoints were progression-free survival (PFS) and overall survival (OS) from osimertinib initiation.

RESULTS

In total, 43 patients were included (mean age 84.6 years; women 90.7%: adenocarcinoma 100%; never smokers 90.5%; at osimertinib initiation: performance status ≥ 2, 42.4%; stage 4, 93.0%; brain metastases 16.3%). Patients received a median of two lines of treatment before osimertinib initiation, and all received first- or second-generation EGFR TKIs before osimertinib (first line in 79.1%). Osimertinib was used as a second-line treatment in 41.9% of cases and third line or more in 58.1%. Median PFS was 17.5 (95% confidence interval [CI] 12.2-19.0) months for the entire population: 20.6 (95% CI 18.8-not reached) months in patients with brain metastases and 16.7 (95% CI 10.4-18.9) months in patients without (p = 0.1). There was no significant difference for osimertinib treatment as second or third line or more (17.1 vs. 18.6 months, respectively). OS was 22.8 (95% CI 15.7-not reached) months from osimertinib initiation.

CONCLUSION

The efficacy of osimertinib as second-line treatment or more in octogenarian pretreated patients with EGFR T790M-mutated advanced NSCLC in a real-life setting was similar to that in randomized controlled trials.

Authors+Show Affiliations

Service de Pneumologie et Oncologie Thoracique, Hôpital F. Quesnay, 2 Boulevard de Sully, 78200, Mantes-la-Jolie, France. j-b.auliac@ch-mantes-la-jolie.fr.Pneumologie, CH François Quesnay, Mantes-la-Jolie, France.Pneumologie, CHU Saint Denis, site Félix Guyon, Réunion, France.Pneumologie, CHU Caen Normandie, Caen, France.Pneumologie, CHRU Brest, site Hôpital Morvan, Brest, France.Pneumologie, CH Cholet, Cholet, France.Pneumologie, CHU Limoges, Limoges, France.Oncologie, CH Bretagne Sud, Lorient, France.Pneumologie, Hôpital Robert Schuman, Metz, France.Pneumologie, CH de Cornouaille, Quimper, France.Pneumologie, CH Elbeuf, Saint-Aubin-lès-Elbeuf, France.Oncologie, Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France.Pneumologie, Hôpital Pontchaillou, Rennes, France.Service de Pneumologie et Oncologie Thoracique, Hôpital F. Quesnay, 2 Boulevard de Sully, 78200, Mantes-la-Jolie, France.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31119481

Citation

Auliac, Jean-Bernard, et al. "Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients With T790M-Mutated Advanced Non-small Cell Lung Cancer." Targeted Oncology, vol. 14, no. 3, 2019, pp. 307-314.
Auliac JB, Saboundji K, Andre M, et al. Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer. Target Oncol. 2019;14(3):307-314.
Auliac, J. B., Saboundji, K., Andre, M., Madelaine, J., Quere, G., Masson, P., Vergnenegre, A., Lamy, R., Raymond, S., Chiappa, A. M., Hauss, P. A., Fournel, P., Corre, R., & Chouaid, C. (2019). Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer. Targeted Oncology, 14(3), 307-314. https://doi.org/10.1007/s11523-019-00646-4
Auliac JB, et al. Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients With T790M-Mutated Advanced Non-small Cell Lung Cancer. Target Oncol. 2019;14(3):307-314. PubMed PMID: 31119481.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Real-Life Efficacy of Osimertinib in Pretreated Octogenarian Patients with T790M-Mutated Advanced Non-small Cell Lung Cancer. AU - Auliac,Jean-Bernard, AU - Saboundji,Karima, AU - Andre,Michel, AU - Madelaine,Jeannick, AU - Quere,Gilles, AU - Masson,Philippe, AU - Vergnenegre,Alain, AU - Lamy,Régine, AU - Raymond,Stéphane, AU - Chiappa,Anne-Marie, AU - Hauss,Pierre-Alexandre, AU - Fournel,Pierre, AU - Corre,Romain, AU - Chouaid,Christos, PY - 2019/5/24/pubmed PY - 2020/3/3/medline PY - 2019/5/24/entrez SP - 307 EP - 314 JF - Targeted oncology JO - Target Oncol VL - 14 IS - 3 N2 - BACKGROUND: The resistance mutation T790M is reported in 50-60% of patients pretreated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Osimertinib has been approved in these patients, but data in octogenarians remain rare. OBJECTIVE: The objective of this retrospective analysis was to evaluate in real life the efficacy of osimertinib in a population of octogenarian patients. METHODS: This retrospective multicentric study included pretreated octogenarian patients with EGFR T790M-mutated advanced non-small cell lung cancer (NSCLC) in the setting of the French early access program for osimertinib. The primary endpoints were progression-free survival (PFS) and overall survival (OS) from osimertinib initiation. RESULTS: In total, 43 patients were included (mean age 84.6 years; women 90.7%: adenocarcinoma 100%; never smokers 90.5%; at osimertinib initiation: performance status ≥ 2, 42.4%; stage 4, 93.0%; brain metastases 16.3%). Patients received a median of two lines of treatment before osimertinib initiation, and all received first- or second-generation EGFR TKIs before osimertinib (first line in 79.1%). Osimertinib was used as a second-line treatment in 41.9% of cases and third line or more in 58.1%. Median PFS was 17.5 (95% confidence interval [CI] 12.2-19.0) months for the entire population: 20.6 (95% CI 18.8-not reached) months in patients with brain metastases and 16.7 (95% CI 10.4-18.9) months in patients without (p = 0.1). There was no significant difference for osimertinib treatment as second or third line or more (17.1 vs. 18.6 months, respectively). OS was 22.8 (95% CI 15.7-not reached) months from osimertinib initiation. CONCLUSION: The efficacy of osimertinib as second-line treatment or more in octogenarian pretreated patients with EGFR T790M-mutated advanced NSCLC in a real-life setting was similar to that in randomized controlled trials. SN - 1776-260X UR - https://www.unboundmedicine.com/medline/citation/31119481/Real_Life_Efficacy_of_Osimertinib_in_Pretreated_Octogenarian_Patients_with_T790M_Mutated_Advanced_Non_small_Cell_Lung_Cancer_ L2 - https://dx.doi.org/10.1007/s11523-019-00646-4 DB - PRIME DP - Unbound Medicine ER -