Author of

• 31515

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  P2.14 - Targeted Therapy (ID 183)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Targeted Therapy
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31519

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    P2.14-03 - Predictive Factors of Osimertinib as Salvage Treatment for Metastatic EGFR T790M Positive Lung Adenocarcinoma (Now Available) (ID 1716)

    10:15 - 18:15  |  Author(s): Ji Young Park
    • Abstract
    • Slides

    Background
    

    EGFR T790M mutation is a robust biomarker for the efficacy of osimertinib. But its clinical efficacy is very limited in a part of patients with non-small cell lung cancer harboring EGFR T790M mutation, suggesting primary resistance. The purpose of this study was to discover clinical predictive factors for the efficacy of osimertinib

    Method
    

    This retrospective study analyzed patients with stage IV, EGFR T790M positive lung adenocarcinoma given osimertinib as salvage treatment. Various baseline clinical factors were investigated according to favorable or unfavorable osimertinib efficacy group. Unfavorable efficacy (primary resistant) group was defined as progression-free survival (PFS) < 6 months with osimertinib.

    Result
    

    Thirty patients were eligible for this analysis (19 of favorable and 11 of unfavorable efficacy group). PFS of favorable and unfavorable efficacy group with osimertinib were 9.9 months (95% CI 9.5-10.3) and 3.3 months (95% CI 2.4-4.2), respectively (p<0.001). Response rate of osimertinib was 89.5% vs. 18.2% (p<0.001). The cases with age at the time of lung cancer diagnosis ≥ 60 years, baseline (before starting osimertinib) Neutrophil to Lymphocyte Ratio (NLR) ≤ 3.5, pre-osimertinib treatment with first generation EGFR-TKI (gefintinib or erlotinib) rather than second generation EGFR-TKI (afatinib) were more frequent in the favorable efficacy group (p=0.058, 0.058, and 0.088, respectively, chi-square test). Age at the time of lung cancer diagnosis, ECOG performance, baseline NLR, pre-osimertinib EGFR-TKI generation, and PFS with previous EGFR-TKI were revealed as potential predictive factors through Kaplan-Meier PFS estimation. Finally, Cox proportional hazard regression analysis confirmed age at the time of lung cancer diagnosis ≥ 60 years (HR 0.292, 95% CI 0.104-0.819, p=0.019) and baseline NLR ≤ 3.5 (HR 0.238, 95% CI 0.083-0.677, p=0.007) were good predictive factors for the efficacy of osimertinib

    Conclusion
    

    Relatively old age and low neutrophilic inflammation were associated with favorable efficacy of osimertinib.

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