Start Your Search
Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
163P - The influence of 2<sup>nd</sup> and 3<sup>rd</sup> generation TKI in EGFR mt+ and ALK+ patients on OS and PFS: Results of the NOWEL network (ID 402)
12:30 - 13:00 | Author(s): A. Lueers
EGFR TKI treatment is standard of care in patients with metastasized NSCLC carrying an activating EGFR mutation. Targeted therapies achieve a higher ORR, OS, PFS and a better quality of life than chemotherapy in mt+ patients. With the advent of 2[nd] and 3[rd] generation TKÍs effective in 1[st] generation TKI resistant tumors, we wanted to study the impact of these drugs on the outcome of patients in a real life setting in 3 lung cancer centers.
1477 patients from three cancer centers diagnosed with non-squamous cell NSCLC stage IV (UICC 7) were examined. Methods for the mutation testing was performed according to the German Oncopedia guidelines using either Sanger Sequencing or COBAS® or Next Generation Sequencing (hybrid capture NGS, New Oncology Cologne).
945/1477 (64%) consecutive patients with non-squamous cell NSCLC from three cancer centers were studied for the presence of tumor mutations, especially for EGFR and ALK mutations. The EGFR mutation rate was 16% (149/912), and the ALK-translocation rate 4% (26/700). Median OS in EGFR mt+ patients was 23 months (n = 154) compared to 11 months (n = 763) in patients with EGFR WT (p < 0.001). Median OS in EGFR mt+ patients depending on the center was 23 (n = 102) vs. 28 (n = 38) vs. 16 (n = 14) months respectively (center 1 vs. center 2 vs. center 3). Median OS in ALK mt+ patients was 24 months (n = 19) in center 1, 11 months (n = 5) in center 2 and in center 3 median OS was not reached (p < 0.025). The use of 3[rd] generation TKI Osimertinib lead to a significantly higher OS (n = 21, median OS 55 months) than the use of only 1[st] and 2[nd] generation TKI (n = 118, median OS 22 months, p < 0.001). The hazard ratio HR for patients treated without Osimertinib was 2.77 [95% CI 1.454–5.305] (p < 0.002). Similarly, use of 2[nd] and 3[rd] generation ALKi impacted significantly on median OS: Crizotinib alone (n = 7), 17 months, Crizotinib followed by Ceritinib and/or Brigatinib/Alectinib (n = 13) median OS was not reached and 3 months for other therapies (n = 6) (p < 0.000).
Small differences in OS were observed, depending on the treatment centers, but the use of multiple EGFR and ALK-I impacted highly significantly on the outcome of patients with EGFR and ALK-alterations in a real life setting.
Clinical trial identification:
Legal entity responsible for the study:
University of Oldenburg
Has not received any funding
M. Netchaeva: Advisory Boards: Roche, AstraZeneca, BMS Travel: Boehringer-Ingelheim, Celegene, Pharma Mar, Amgen Consultant: Boehringer-Ingelheim. M. Falk: Advisory boards: Boehringer Ingelheim, Pfizer, Roche. M. Tiemann: Advisory boards: Novartis, Boehringer, Roche, Astra Zeneca Scientific Support: Novartis F. Griesinger: Advisory Boards: Ariad, Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myer-Squibb, Celgene, Clovis, Lilly, Merck-Sharp-Dome, Novartis, Pfizer, Roche Travel Support: Ariad, Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myer-Squibb, Celgene, Lilly, Merck-Sharp-Dome, Novartis, Pfizer, Roche Scientific Support: Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myer-Squibb, Celgene, Lilly, Merck-Sharp-Dome, Novartis, Pfizer, Roche Shares: none. All other authors have declared no conflicts of interest.
Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.