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- W4313367813 abstract "Despite the remarkable efficacy of osimertinib in epidermal growth factor receptor (EGFR) T790M-positive non-small cell lung cancer (NSCLC), the development of resistance is inevitable. We aimed to analyze the disease progression pattern during osimertinib treatment to identify potential treatment strategies. We retrospectively identified patients with advanced NSCLC who began osimertinib treatment after progression on previous EGFR-TKI between June 2014 and November 2018. Patient characteristics, efficacy outcomes, radiological sites of metastases, and treatment modalities before and after osimertinib were analyzed. Eighty-four patients were included. On osimertinib initiation, bone (50.0%) and brain (41.9%) were the most common single metastatic sites, whereas thoracic involvement (73.3%) was more frequent than bone (27.4%) or brain (20.2%) metastasis during disease progression on osimertinib. Oligo-progressive disease (PD) and central nervous system (CNS)-sanctuary PD were observed in 15 (17.9%) and 3 (3.6%) patients, respectively. Most patients without brain metastasis (BM) at the initiation of osimertinib administration remained BM-free (46/49, 93.9%), and 60% of patients (21/35) with pre-existing BM showed intracranial disease control despite extracranial PD. The mechanism of resistance to osimertinib was explored in 23 patients (27.4%), and T790M-loss was observed in 13 patients (56.5%); these 13 patients had worse survival outcomes than patients without T790M-loss (progression-free survival 6.1 months vs. 13.9 months, P=0.04, overall survival 44.9 months vs. not reached, P=0.03). PD during osimertinib treatment preferentially occurred in the thorax and pre-existing sites. Extracranial PD prevailed over intracranial PD regardless of baseline BM and prior brain radiation. These results support the intracranial efficacy of osimertinib and may guide treatment strategies for EGFR-mutated NSCLC with BM." @default.
- W4313367813 created "2023-01-06" @default.
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- W4313367813 date "2022-12-01" @default.
- W4313367813 modified "2023-09-26" @default.
- W4313367813 title "PP217 Dynamics of disease progression during treatment with osimertinib in patients with EGFR T790M-positive non-small cell lung cancer" @default.
- W4313367813 doi "https://doi.org/10.1016/j.esmoop.2022.100718" @default.
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