PP215 Differential efficacy of tyrosine kinase inhibitors (TKIs) according to the type of EGFR activating mutations and agents in non-small cell lung cancer (NSCLC): A real-world study

ESMO Open

article

T-H. Kim¹  Y.W. Choi¹  M.S. Ahn¹  H.W. Lee¹  S.Y. Kang¹  J-H. Choi¹ 

[1] Department of Hematology-Oncology, Ajou University School of Medicine

关键词: EGFR;    Lung Cancer;    Tyrosine Kinase Inhibitor;   

DOI  :  10.1016/j.esmoop.2022.100717

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background: Both 1st and 2nd-generation (gen) EGFR-TKIs are recommended inadvanced NSCLC with EGFR activating mutations. However, there are few data aboutthe difference in the efficacy of EGFR-TKIs according to type of EGFR mutations andagents.Methods: This retrospective real-world study evaluated the outcome and clinicopathologic characteristics including the type of EGFR activating mutations in 214advanced NSCLC patients (pts) treated with 1st or 2nd-gen (afatinib) EGFR TKIs asfirst-line therapy.Results: The median progression-free survival (PFS) and overall-survival (OS) of all ptswere 12 months (M) and 26M, respectively. In univariate analysis, pts with exon 19deletion (del) (n¼130) tended to have a longer median OS compared to those withL858R mutation (n¼84) (30 vs. 22 M, p¼0.071), without difference in PFS (p¼0.472).Pts treated with afatinib (n¼56) had a tendency of longer median OS compared tothose treated with 1st gen TKIs (gefitinib: 142, erlotinib: 16) (30 vs. 24 M, p¼0.068).In pts with exon 19 del, there was no significant difference in median PFS (p¼0.868)and OS (p¼0.361) between pts treated with afatinib and those with 1st gen TKIs,while a trend in better PFS (14 vs. 10 M, p¼0.071) was observed in pts receivingafatinib without difference in OS (p¼0.160) in L858R mutation. Exon 19 del wasindependently associated with favorable OS (p¼0.040), while age >70 years(p¼0.026), ECOG performance status 2 (p¼0.005), and primary metastatic disease(p¼0.003) were independent prognostic factors of poor OS.Conclusions: The EGFR exon 19 del was associated with favorable outcome inadvanced NSCLC pts receiving first-line TKIs, regardless of the type of agents. Themutation subtypes should be considered when selecting TKIs for pts with EGFRactivating mutations.

【 授权许可】

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