Final Report on Real-World Effectiveness of Sequential Afatinib and Osimertinib in EGFR-Positive Advanced Non–Small Cell Lung Cancer: Updated Analysis of the RESET Study
- Author:
Taeyun KIM
1
;
Tae Won JANG
;
Chang Min CHOI
;
Mi-Hyun KIM
;
Sung Yong LEE
;
Yoon Soo CHANG
;
Kye Young LEE
;
Seung Joon KIM
;
Sei Hoon YANG
;
Jeong Seon RYU
;
Jeong Eun LEE
;
Shin Yup LEE
;
Chan Kwon PARK
;
Sang Hoon LEE
;
Seung Hun JANG
;
Seong Hoon YOON
;
Hyung-Joo OH
Author Information
- Publication Type:Original Article
- From:Cancer Research and Treatment 2023;55(4):1152-1170
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to report the final analysis of time-on-treatment (TOT) and overall survival (OS) in patients with advanced-stage epidermal growth factor receptor (EGFR)+ non–small cell lung cancer (NSCLC) who received sequential afatinib and osimertinib and to compare the outcomes with other second-line regimens (comparator group).
Materials and Methods:In this updated report, the existing medical records were reviewed and rechecked. TOT and OS were updated and analyzed according to clinical features using the Kaplan-Meier method and log-rank test. TOT and OS were compared with those of the comparator group, in which most patients received pemetrexed-based treatments. A multivariable Cox proportional hazard model was used to evaluate features that could affect survival outcomes.
Results:The median observation time was 31.0 months. The follow-up period was extended to 20 months. A total of 401 patients who received first-line afatinib were analyzed (166 with T790M+ and second-line osimertinib, and 235 with unproven T790M and other second-line agents). Median TOTs on afatinib and osimertinib were 15.0 months (95% confidence interval [CI], 14.0 to 16.1) and 11.9 months (95% CI, 8.9 to 14.6), respectively. The median OS in the osimertinib group was 54.3 months (95% CI, 46.7 to 61.9), much longer than that in the comparator group. In patients who received osimertinib, the OS was longest with Del19+ (median, 59.1; 95% CI, 48.7 to 69.5).
Conclusion:This is one of the largest real-world studies reporting the encouraging activity of sequential afatinib and osimertinib in Asian patients with EGFR+ NSCLC who acquired the T790M mutation, particularly Del19+.
