Eric Nadler1, Melissa Pavilack2, Janet L Espirito3, Jamyia Clark3, Ancilla Fernandes2. 1. US Oncology Health Informatics and Internet Technology, Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA. eric.nadler@usoncology.com. 2. Health Economics and Outcomes Research, AstraZeneca US, Gaithersburg, MD, USA. 3. Outcomes Research, McKesson Life Sciences, The Woodlands, TX, USA.
Abstract
INTRODUCTION: Epidermal growth factor receptor (EGFR) mutations are observed in approximately 15% of patients with non-small cell lung cancer (NSCLC) in the USA. Little is known about treatment patterns in EGFR mutation-positive NSCLC following progression on or after first-line (1L) treatment with first- or second-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs). Osimertinib, a third-generation EGFR-TKI, is a treatment option for patients with EGFR T790M-positive NSCLC following progression on 1L EGFR-TKIs. This study analyzed real-world treatment sequencing of EGFR-TKIs, EGFR T790M testing rates, and disposition of patients with EGFR mutations after 1L EGFR-TKI post-FDA approval of osimertinib in patients with EGFR mutation-positive NSCLC. METHODS: Adult patients with stage IV NSCLC and documented EGFR mutation-positive status were identified between December 1, 2015 and May 31, 2017 from the US Oncology Network iKnowMed™ electronic health record (EHR). Data were abstracted from the EHR database and supplemented by chart review. RESULTS: Of 308 patients, 302 (98%) received an EGFR-TKI overall, and 246 patients (80%) received a 1L EGFR-TKI. The most common 1L EGFR-TKI was erlotinib (66%); the remaining 1L regimens were predominantly combination chemotherapies with or without an EGFR-TKI. Only 80 patients (26%) received any 2L therapy. The most common EGFR-TKIs used as 2L monotherapy in patients who received 1L EGFR-TKI were afatinib and osimertinib (n = 7 for both). Among all patients treated with 1L EGFR-TKI (n = 246), 47 (19%) were tested for EGFR T790M [16 patients (34%) were positive], 48 (20%) remained on 1L EGFR-TKI, 29 (12%) received subsequent therapy, 38 (15%) had died on or after their 1L EGFR-TKI therapy, and 131 (53%) stopped their EGFR-TKI with no recorded evidence of having received subsequent therapy at follow-up end. CONCLUSION: Following 1L EGFR-TKI treatment, 19% of patients were tested for EGFR T790M, and most (69%) had no record of receiving any subsequent therapy.
INTRODUCTION:Epidermal growth factor receptor (EGFR) mutations are observed in approximately 15% of patients with non-small cell lung cancer (NSCLC) in the USA. Little is known about treatment patterns in EGFR mutation-positive NSCLC following progression on or after first-line (1L) treatment with first- or second-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs). Osimertinib, a third-generation EGFR-TKI, is a treatment option for patients with EGFRT790M-positive NSCLC following progression on 1L EGFR-TKIs. This study analyzed real-world treatment sequencing of EGFR-TKIs, EGFRT790M testing rates, and disposition of patients with EGFR mutations after 1L EGFR-TKI post-FDA approval of osimertinib in patients with EGFR mutation-positive NSCLC. METHODS: Adult patients with stage IV NSCLC and documented EGFR mutation-positive status were identified between December 1, 2015 and May 31, 2017 from the US Oncology Network iKnowMed™ electronic health record (EHR). Data were abstracted from the EHR database and supplemented by chart review. RESULTS: Of 308 patients, 302 (98%) received an EGFR-TKI overall, and 246 patients (80%) received a 1L EGFR-TKI. The most common 1L EGFR-TKI was erlotinib (66%); the remaining 1L regimens were predominantly combination chemotherapies with or without an EGFR-TKI. Only 80 patients (26%) received any 2L therapy. The most common EGFR-TKIs used as 2L monotherapy in patients who received 1L EGFR-TKI were afatinib and osimertinib (n = 7 for both). Among all patients treated with 1L EGFR-TKI (n = 246), 47 (19%) were tested for EGFRT790M [16 patients (34%) were positive], 48 (20%) remained on 1L EGFR-TKI, 29 (12%) received subsequent therapy, 38 (15%) had died on or after their 1L EGFR-TKI therapy, and 131 (53%) stopped their EGFR-TKI with no recorded evidence of having received subsequent therapy at follow-up end. CONCLUSION: Following 1L EGFR-TKI treatment, 19% of patients were tested for EGFRT790M, and most (69%) had no record of receiving any subsequent therapy.
Authors: Giulia Pasello; Martina Lorenzi; Giulia Pretelli; Giovanni Maria Comacchio; Federica Pezzuto; Marco Schiavon; Alessandra Buja; Stefano Frega; Laura Bonanno; Valentina Guarneri; Fiorella Calabrese; Federico Rea Journal: Front Oncol Date: 2022-06-29 Impact factor: 5.738
Authors: Nikolaus Magios; Farastuk Bozorgmehr; Anna-Lena Volckmar; Daniel Kazdal; Martina Kirchner; Felix J Herth; Claus-Peter Heussel; Florian Eichhorn; Michael Meister; Thomas Muley; Rami A Elshafie; Jürgen R Fischer; Martin Faehling; Mark Kriegsmann; Peter Schirmacher; Helge Bischoff; Albrecht Stenzinger; Michael Thomas; Petros Christopoulos Journal: Ther Adv Med Oncol Date: 2021-03-24 Impact factor: 8.168
Authors: Ross A Soo; Takashi Seto; Jhanelle E Gray; Ellen Thiel; Aliki Taylor; William Sawyer; Parisa Karimi; Elizabeth Marchlewicz; Matthew Brouillette Journal: Drugs Real World Outcomes Date: 2021-09-12