Introduction: Current treatment guidelines for patients with epidermal growth factor receptor (EGFR)-mutated metastatic non-small cell lung cancer (mNSCLC) recommend EGFR tyrosine kinase inhibitors (TKIs) as the standard of care for first-line treatment, with third-generation osimertinib the preferred choice. However, most patients develop resistance to targeted therapy, and subsequent systemic chemotherapy is recommended. The aim of this study was to characterize the subsequent line of therapy (LOT) following osimertinib in patients with EGFR-mNSCLC.
Methods: Medical and pharmacy claims of adults who initiated a subsequent LOT (index) after initial osimertinib discontinuation between November 2015 and September 2019 were analyzed retrospectively.
Results: A total of 135 patients met the inclusion criteria. After metastatic diagnosis, 22.2% and 49.6% of patients were treated with osimertinib in the first and second line, respectively. After osimertinib discontinuation, most patients were treated with a platinum-based chemotherapy regimen (57%), of which 40.3% included immuno-oncology therapy. Reuse or continuation of EGFR TKIs was also common (24%). Overall, the median time to treatment discontinuation for the index LOT was 2.4 months. Proportions of patients with ≥ 1 inpatient or emergency department visit were 31.9% and 35.6%, respectively.
Conclusions: The duration of the LOT following osimertinib was short and associated with tolerability issues underscoring a high unmet need for new therapies to address EGFR TKI resistance.
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http://dx.doi.org/10.1007/s40487-024-00292-5 | DOI Listing |
Cureus
December 2024
Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, JPN.
We report a rare case of concurrent onset of osimertinib-induced heart failure and metronidazole-induced encephalopathy during treatment of a brain abscess. A 78-year-old female with lung adenocarcinoma presented with neurological symptoms and was diagnosed with a brain abscess. During treatment, she developed heart failure and encephalopathy, linked to osimertinib and metronidazole, respectively.
View Article and Find Full Text PDFJ Thorac Oncol
January 2025
Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa-Nishi-machi, Kanagawa-ku, Yokohama 221-0855, Japan.
Introduction: Osimertinib is the first-line treatment for patients with non-small cell lung cancer (NSCLC) who have EGFR mutations and favorable performance status (PS). Despite increasing clinical data on osimertinib, evidence in patients with an impaired PS remains limited. Therefore, a multicenter phase II trial (OPEN/TORG2040) was conducted to evaluate the efficacy and safety of first-line osimertinib for patients with EGFR mutation-positive NSCLC and poor PS.
View Article and Find Full Text PDFThorac Cancer
December 2024
Department of Chemotherapy, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan.
Introduction: First-line osimertinib is widely used to treat patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancers (NSCLC). In clinical practice, rechallenge therapy with another EGFR-tyrosine kinase inhibitor (TKI) is often performed after first-line TKI discontinuation owing to resistance or toxicity; however, the efficacy and toxicity of EGFR-TKI rechallenge after first-line osimertinib have not been adequately investigated. This study aimed to examine the efficacy and safety of EGFR-TKI rechallenge with another TKI.
View Article and Find Full Text PDFJ Thorac Oncol
November 2024
Department of Thoracic Oncology, LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany.
Introduction: RELAY, a global double-blind, placebo-controlled phase 3 study (NCT02411448) found statistically significant improvement in progression-free survival (primary end point) for ramucirumab (RAM) plus erlotinib (ERL) (RAM + ERL) in patients with untreated EGFR-mutated metastatic NSCLC (hazard ratio [HR] = 0.59, 95% confidence interval [CI]: 0.46-0.
View Article and Find Full Text PDFJ Thorac Dis
October 2024
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are effective for non-small cell lung cancer (NSCLC) patients with -mutation, while their toxicity profiles are non-negligible and inconsistent. This study aimed to assess the toxicity intensity and profiles of different EGFR-TKIs in NSCLC patients with -mutation.
Methods: This random-effect Bayesian framed network meta-analysis (NMA) only included exclusively randomized clinical trials with demonstrated evidence on safety of EGFR-TKIs in NSCLC patients with EGFR-mutation.
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