Intercalated treatment following rebiopsy is associated with a shorter progression-free survival of osimertinib treatment
Journal
Cancer Research and Treatment
Journal Volume
50
Journal Issue
4
Pages
1164-1174
Date Issued
2018
Author(s)
Abstract
Purpose Epidermal growth factor receptor (EGFR) T790M mutation serves as an important predictor of osimertinib efficacy. However, little is known about how it works among patients with various timings of T790M emergence and treatment. Materials and Methods Advanced EGFR-mutant lung adenocarcinoma patients with positive T790M mutation in tumor were retrospectively enrolled and observed to determine the outcomes of osimertinib treatment. We evaluated the association between patients' characteristics and the efficacy of osimertinib treatment, particularly with respect to the timing of T790M emergence and osimertinib prescription. Results A total of 91 patients were enrolled, including 14 (15.4%) with primary and 77 (84.6%) with acquired T790M mutation. The objective response rate and disease control rate were 60.9% and 85.1%, respectively. The median progression-free survival (PFS) and overall survival were 11.5 months (95% confidence interval [CI], 9.0 to 14.0) and 30.4 months (95% CI, 11.3 to 49.5), respectively. There was no significant difference in response rate and PFS between primary and acquired T790M populations. In the acquired T790M subgroup, patients who received osimertinib after T790M had been confirmed by rebiopsy had a longer PFS than those with intercalated treatments between rebiopsy and osimertinib prescription (14.0 months [95% CI, 9.0 to 18.9] vs. 7.2 months [95% CI, 3.7 to 10.8]; adjusted hazard ratio, 0.48 [95% CI, 0.24 to 0.98; p=0.043]). Rebiopsy timing did not influence the outcome. Conclusion Osimertinib prescription with intercalated treatment following rebiopsy but not the timing of T790M emergence influenced the treatment outcome. We suggest that it is better to start osimertinib treatment once T790M mutation has been confirmed by biopsy. ? 2018 by the Korean Cancer Association.
SDGs
Other Subjects
epidermal growth factor receptor; osimertinib; EGFR protein, human; epidermal growth factor receptor; osimertinib; piperazine derivative; protein kinase inhibitor; advanced cancer; aged; Article; cancer control; cancer genetics; cancer patient; drug efficacy; female; gene mutation; human; lung adenocarcinoma; major clinical study; male; outcome assessment; overall survival; prescription; progression free survival; retrospective study; tumor biopsy; biopsy; genetics; lung tumor; middle aged; mutation; non small cell lung cancer; treatment outcome; Biopsy; Carcinoma, Non-Small-Cell Lung; ErbB Receptors; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Piperazines; Progression-Free Survival; Protein Kinase Inhibitors; Retrospective Studies; Treatment Outcome
Type
journal article