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Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI.
Target Oncol. 2020 Aug; 15(4):503-512.TO

Abstract

BACKGROUND

Osimertinib is effective in non-small-cell lung cancer (NSCLC) with an acquired epidermal growth factor receptor (EGFR) T790M mutation, the most common resistance mechanism to first- and second-generation EGFR tyrosine kinase inhibitors (TKIs).

OBJECTIVES

We aimed to evaluate survival outcome of patients with EGFR-mutant NSCLC who have progressed on previous EGFR TKI therapy.

PATIENTS AND METHODS

Advanced NSCLC patients with EGFR mutation after acquired resistance to first- or second-generation EGFR TKI who received tumor rebiopsy after EGFR TKI failure from 1 January 2012 to 31 December 2017 were reviewed. Patient clinical characteristics, T790M mutation status, and post-progression survival (PPS) were recorded by chart review.

RESULTS

We included 240 patients and the percentage of secondary T790M mutations in first time tissue rebiopsy was 52.9%. 38 of the initial T790M-negative patients received second rebiopsies and 14 (36.8%) of these were T790M positive. The duration between first and second rebiopsy tended to be longer in patients who had T790M mutation in the second biopsy (11.5 vs. 6.9 months, p = 0.043). After EGFR TKI failure, the median PPS of patients who had the T790M mutation and history of osimertinib use was 42.6 months (95% CI 34.6-50.5), compared to 18.0 (95% CI 9.6-26.4) months in T790M-positive patients without a history of osimertinib use, and 18.8 (95% CI 9.3-28.4) months in patients with no T790M mutation (p < 0.0001). Multivariate analysis showed that history of osimertinib use was correlated with improved survival.

CONCLUSIONS

These data further emphasize that osimertinib should be a standard of care in patients with pretreated EGFR T790M-positive NSCLC.

Authors+Show Affiliations

Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan.Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. jhchiou@vghtpe.gov.tw. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. jhchiou@vghtpe.gov.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32696212

Citation

Chiang, Chi-Lu, et al. "Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI." Targeted Oncology, vol. 15, no. 4, 2020, pp. 503-512.
Chiang CL, Huang HC, Shen CI, et al. Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI. Target Oncol. 2020;15(4):503-512.
Chiang, C. L., Huang, H. C., Shen, C. I., Luo, Y. H., Chen, Y. M., & Chiu, C. H. (2020). Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI. Targeted Oncology, 15(4), 503-512. https://doi.org/10.1007/s11523-020-00737-7
Chiang CL, et al. Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI. Target Oncol. 2020;15(4):503-512. PubMed PMID: 32696212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-Progression Survival in Secondary EGFR T790M-Mutated Non-Small-Cell Lung Cancer Patients With and Without Osimertinib After Failure of a Previous EGFR TKI. AU - Chiang,Chi-Lu, AU - Huang,Hsu-Ching, AU - Shen,Chia-I, AU - Luo,Yung-Hung, AU - Chen,Yuh-Min, AU - Chiu,Chao-Hua, PY - 2020/7/23/pubmed PY - 2020/7/23/medline PY - 2020/7/23/entrez SP - 503 EP - 512 JF - Targeted oncology JO - Target Oncol VL - 15 IS - 4 N2 - BACKGROUND: Osimertinib is effective in non-small-cell lung cancer (NSCLC) with an acquired epidermal growth factor receptor (EGFR) T790M mutation, the most common resistance mechanism to first- and second-generation EGFR tyrosine kinase inhibitors (TKIs). OBJECTIVES: We aimed to evaluate survival outcome of patients with EGFR-mutant NSCLC who have progressed on previous EGFR TKI therapy. PATIENTS AND METHODS: Advanced NSCLC patients with EGFR mutation after acquired resistance to first- or second-generation EGFR TKI who received tumor rebiopsy after EGFR TKI failure from 1 January 2012 to 31 December 2017 were reviewed. Patient clinical characteristics, T790M mutation status, and post-progression survival (PPS) were recorded by chart review. RESULTS: We included 240 patients and the percentage of secondary T790M mutations in first time tissue rebiopsy was 52.9%. 38 of the initial T790M-negative patients received second rebiopsies and 14 (36.8%) of these were T790M positive. The duration between first and second rebiopsy tended to be longer in patients who had T790M mutation in the second biopsy (11.5 vs. 6.9 months, p = 0.043). After EGFR TKI failure, the median PPS of patients who had the T790M mutation and history of osimertinib use was 42.6 months (95% CI 34.6-50.5), compared to 18.0 (95% CI 9.6-26.4) months in T790M-positive patients without a history of osimertinib use, and 18.8 (95% CI 9.3-28.4) months in patients with no T790M mutation (p < 0.0001). Multivariate analysis showed that history of osimertinib use was correlated with improved survival. CONCLUSIONS: These data further emphasize that osimertinib should be a standard of care in patients with pretreated EGFR T790M-positive NSCLC. SN - 1776-260X UR - https://www.unboundmedicine.com/medline/citation/32696212/Post_Progression_Survival_in_Secondary_EGFR_T790M_Mutated_Non_Small_Cell_Lung_Cancer_Patients_With_and_Without_Osimertinib_After_Failure_of_a_Previous_EGFR_TKI_ L2 - https://dx.doi.org/10.1007/s11523-020-00737-7 DB - PRIME DP - Unbound Medicine ER -
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