Jean-Bernard Auliac1, Karima Saboundji2, Michel Andre3, Jeannick Madelaine4, Gilles Quere5, Philippe Masson6, Alain Vergnenegre7, Régine Lamy8, Stéphane Raymond9, Anne-Marie Chiappa10, Pierre-Alexandre Hauss11, Pierre Fournel12, Romain Corre13, Christos Chouaid14. 1. 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. 2. Pneumologie, CH François Quesnay, Mantes-la-Jolie, France. 3. Pneumologie, CHU Saint Denis, site Félix Guyon, Réunion, France. 4. Pneumologie, CHU Caen Normandie, Caen, France. 5. Pneumologie, CHRU Brest, site Hôpital Morvan, Brest, France. 6. Pneumologie, CH Cholet, Cholet, France. 7. Pneumologie, CHU Limoges, Limoges, France. 8. Oncologie, CH Bretagne Sud, Lorient, France. 9. Pneumologie, Hôpital Robert Schuman, Metz, France. 10. Pneumologie, CH de Cornouaille, Quimper, France. 11. Pneumologie, CH Elbeuf, Saint-Aubin-lès-Elbeuf, France. 12. Oncologie, Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France. 13. Pneumologie, Hôpital Pontchaillou, Rennes, France. 14. Service de Pneumologie et Oncologie Thoracique, Hôpital F. Quesnay, 2 Boulevard de Sully, 78200, Mantes-la-Jolie, France.
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.
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: Myung-Ju Ahn; Chun-Ming Tsai; Frances A Shepherd; Lyudmila Bazhenova; Lecia V Sequist; Toyoaki Hida; James C H Yang; Suresh S Ramalingam; Tetsuya Mitsudomi; Pasi A Jänne; Helen Mann; Mireille Cantarini; Glenwood Goss Journal: Cancer Date: 2018-12-04 Impact factor: 6.860
Authors: Peter Ballard; James W T Yates; Zhenfan Yang; Dong-Wan Kim; James Chih-Hsin Yang; Mireille Cantarini; Kathryn Pickup; Angela Jordan; Mike Hickey; Matthew Grist; Matthew Box; Peter Johnström; Katarina Varnäs; Jonas Malmquist; Kenneth S Thress; Pasi A Jänne; Darren Cross Journal: Clin Cancer Res Date: 2016-07-19 Impact factor: 12.531
Authors: Jean Bernard Auliac; Maurice Pérol; David Planchard; Isabelle Monnet; Marie Wislez; Hélène Doubre; Florian Guisier; Eric Pichon; Laurent Greillier; Bénédicte Mastroianni; Chantal Decroisette; Roland Schott; Sylvestre Le Moulec; Jennifer Arrondeau; Alexis B Cortot; Laurence Gerinière; Aldo Renault; Catherine Daniel; Lionel Falchero; Christos Chouaid Journal: Lung Cancer Date: 2018-11-27 Impact factor: 5.705
Authors: Darren A E Cross; Susan E Ashton; Serban Ghiorghiu; Cath Eberlein; Caroline A Nebhan; Paula J Spitzler; Jonathon P Orme; M Raymond V Finlay; Richard A Ward; Martine J Mellor; Gareth Hughes; Amar Rahi; Vivien N Jacobs; Monica Red Brewer; Eiki Ichihara; Jing Sun; Hailing Jin; Peter Ballard; Katherine Al-Kadhimi; Rachel Rowlinson; Teresa Klinowska; Graham H P Richmond; Mireille Cantarini; Dong-Wan Kim; Malcolm R Ranson; William Pao Journal: Cancer Discov Date: 2014-06-03 Impact factor: 39.397