Abstract

Objective

This retrospective, observational study examined patient characteristics, treatment patterns, testing patterns, and outcomes of US patients receiving first-/second- or third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).

Methods

This study used an electronic health record-derived de-identified database. Eligible patients had advanced EGFRm⁺ non-small cell lung cancer. Descriptive statistics were used to describe demographic, clinical, and treatment characteristics. Logistic regression models were used to identify patient characteristics that were associated with the use of osimertinib vs. a first-/second-generation EGFR TKI. Kaplan–Meier methods were used for survival analysis.

Results

Of the 782 patients who received first-line (1L) therapy with first-/second-generation EGFR TKIs in cohort A, erlotinib was the most common (58%), and osimertinib was the most widely prescribed second-line (2L) therapy (52%). Of the patients who received 1L therapy with osimertinib, a greater range of treatments were prescribed in 2L. A third of patients treated with first-/second-generation EGFR TKIs underwent EGFR testing near the end of 1L, and 44% of these patients had T790M positive disease. The median time on targeted therapy (TTT) of the cohort was 11.1 months (95% confidence interval [CI] 9.7, 12.3), and the median overall survival from the start of 1L therapy was 23.5 months (95% CI 20.7, 24.8).

Conclusions

The majority of patients treated with first-/second-generation EGFR TKIs went on to receive osimertinib in the 2L setting, but overall, only a third of patients had received molecular testing at progression. Improved testing frequency is vital to inform treatment decisions.

中文翻译：

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研究真实世界的 EGFRm+ 非小细胞肺癌患者的患者特征、治疗模式、EGFR 检测模式和结果

摘要

客观的

这项回顾性观察性研究检查了接受第一代/第二代或第三代表皮生长因子受体 (EGFR) 酪氨酸激酶抑制剂 (TKI) 的美国患者的患者特征、治疗模式、测试模式和结果。

方法

本研究使用电子健康记录衍生的去识别化数据库。符合条件的患者患有晚期EGFR m ⁺非小细胞肺癌。描述性统计用于描述人口统计学、临床和治疗特征。逻辑回归模型用于识别与使用奥希替尼与第一代/第二代 EGFR TKI 相关的患者特征。Kaplan-Meier 方法用于生存分析。

结果

在队列 A 中接受第一代/第二代 EGFR TKI 一线 (1L) 治疗的 782 名患者中，厄洛替尼是最常见的 (58%)，奥希替尼是最广泛使用的二线 (2L) 治疗（52%）。在接受 1L 奥希替尼治疗的患者中，2L 的治疗范围更大。三分之一接受第一代/第二代 EGFR TKI 治疗的患者在接近 1L 结束时接受了EGFR检测，其中 44% 的患者患有 T790M 阳性疾病。该队列的靶向治疗 (TTT) 中位时间为 11.1 个月（95% 置信区间 [CI] 9.7, 12.3），从 1L 治疗开始的中位总生存期为 23.5 个月（95% CI 20.7, 24.8） .

结论

大多数接受第一代/第二代 EGFR TKI 治疗的患者在 2L 环境中继续接受奥希替尼，但总体而言，只有三分之一的患者在进展时接受了分子检测。提高测试频率对于告知治疗决策至关重要。