Osimertinib as first-line treatment for elderly patients with advanced EGFR mutation-positive non-small cell lung cancer in a real-world setting (OSI-FACT-EP)

被引：4

作者：

Sakata, Yoshihiko ^{[1
]}

Saito, Go ^{[2
]}

Sakata, Shinya ^{[3
]}

Oya, Yuko ^{[4
,5
]}

Tamiya, Motohiro ^{[6
]}

Suzuki, Hidekazu ^{[7
]}

Shibaki, Ryota ^{[8
]}

Okada, Asuka ^{[9
]}

Yokoyama, Toshihide ^{[10
]}

Matsumoto, Hirotaka ^{[11
]}

Otsuki, Taiichiro ^{[12
]}

Sato, Yuki ^{[13
]}

Junji, Uchida ^{[14
]}

Tsukita, Yoko ^{[15
]}

Inaba, Megumi ^{[16
]}

Ikeda, Hideki ^{[2
,17
]}

Arai, Daisuke ^{[18
]}

Maruyama, Hirotaka ^{[19
]}

Hara, Satoshi ^{[20
]}

Tsumura, Shinsuke ^{[21
]}

Morinaga, Jun ^{[22
]}

Sakagami, Takuro ^{[3
]}

机构：

[1] Saiseikai Kumamoto Hosp, Div Resp Med, 5-3-1 Chikami,Minami Ku, Kumamoto 8614193, Japan

[2] Chiba Univ, Grad Sch Med, Dept Respirol, 1-8-1 Inohana,Chuo Ku, Chiba, Chiba 2608670, Japan

[3] Kumamoto Univ Hosp, Dept Resp Med, 1-1-1 Honjo,Chuo Ku, Kumamoto 8608556, Japan

[4] Aichi Canc Ctr Hosp, Dept Thorac Oncol, 1-1 Kanokoden,Chikusa Ku, Nagoya, Aichi 4648681, Japan

[5] Fujita Hlth Univ, Sch Med, Dept Resp Med, Kutsukake Cho, Toyoake, Aichi 4701192, Japan

[6] Osaka Int Canc Inst, Dept Thorac Oncol, 3-1-69 Otemae,Chuo Ku, Osaka, Osaka 5418567, Japan

[7] Osaka Habikino Med Ctr, Dept Thorac Oncol, 3-7-1 Habikino, Habikino, Osaka 5838588, Japan

[8] Wakayama Med Univ, Internal Med 3, 811-1 Kimiidera, Wakayama, Wakayama 6418509, Japan

[9] Osaka City Gen Hosp, Dept Med Oncol, 2-13-22 Miyakojima Hondori,Miyakojima Ku, Osaka 5340021, Japan

[10] Kurashiki Cent Hosp, Dept Resp Med, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan

[11] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Resp Med, 2-17-77 Higashinaniwa, Amagasaki, Hyogo 6608550, Japan

[12] Hyogo Med Univ, Dept Resp Med & Hematol, Sch Med, 1-1 Mukogawa Cho, Nishinomiya, Hyogo 6638501, Japan

[13] Kobe City Med Ctr Gen Hosp, Dept Resp Med, 2-1-1 Minatojimaminami,Chuo Ku, Kobe, Hyogo 6500047, Japan

[14] Natl Hosp Org Osaka Toneyama Med Ctr, Dept Thorac Oncol, 5-1-1 Toneyama, Toyonaka, Osaka 5608552, Japan

[15] Tohoku Univ, Grad Sch Med, Dept Resp Med, 1-1 Seiryo,Aoba Ku, Sendai, Miyagi 9808574, Japan

[16] Kumamoto City Hosp, Div Resp Med, 1-5-1 Tainoshima,Minami Ku, Kumamoto 8620965, Japan

[17] Kimitsu Chuo Hosp, Dept Resp Med, 1010 Sakurai, Kisarazu, Chiba 2928535, Japan

[18] Saiseikai Utsunomiya Hosp, Dept Internal Med, 911-1 Takebayashi, Utsunomiya, Tochigi 3210974, Japan

[19] Kumamoto Rosai Hosp, Dept Resp Med, Japan Org Occupat Hlth & Safety, 1670 Takehara, Yatsushiro, Kumamoto 8668533, Japan

[20] Itami City Hosp, Dept Resp Med, 1-100 Koyaike, Itami, Hyogo 6648540, Japan

[21] Kumamoto Reg Med Ctr, Dept Resp Med, 5-16-10 Honjo,Chuo Ku, Kumamoto 8600811, Japan

[22] Kumamoto Univ Hosp, Dept Clin Invest Biostat, 1-1-1 Honjo,Chuo Ku, Kumamoto 8608556, Japan

来源：

LUNG CANCER | 2023年 / 186卷

关键词：

Non-small cell lung cancer; EGFR mutation; First-line therapy; Osimertinib; Elderly; Real world; FACTOR RECEPTOR MUTATIONS; OPEN-LABEL; PHASE-II; GEFITINIB; CHEMOTHERAPY; MULTICENTER; ERLOTINIB; AFATINIB;

D O I：

10.1016/j.lungcan.2023.107426

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Osimertinib is the primary treatment for patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer. However, evidence of the outcomes of osimertinib treatment in patients over 75 years of age in the real-world setting is limited.Materials and Methods: This retrospective study analyzed the data of 538 patients (203 elderly and 335 non -elderly) with EGFR mutation-positive lung cancer in whom osimertinib was initiated as first-line treatment between August 2018 and December 2019. Patients over 75 years of age were classified as elderly. The data cut-off date was February 28, 2022.Results: The progression-free survival (PFS) did not significantly differ between the elderly and non-elderly groups [elderly group: median PFS, 16.9 months (95 % confidence interval (CI), 14.3-20.2); non-elderly group: median PFS, 22.1 months (95 % CI: 19.5-26.3); hazard ratio (HR) for the elderly against the non -elderly: 1.21 (95 % CI: 0.98-1.50), p = 0.079]. However, the time to treatment failure (TTF) was significantly shorter in the elderly than in the non-elderly [elderly group: median TTF, 14.0 months (95 % CI: 0.98-1.50); non -elderly group: median TTF, 21.8 months (95 % CI: 18.2-24.6); HR for the elderly against the non-elderly: 1.46 (95 % CI: 1.20-1.77), p < 0.001]. Furthermore, the rate of treatment discontinuation because of adverse events was 28.6 % in the elderly and 14.9 % in the non-elderly (p < 0.001). Among patients who discontinued treat-ment, the conversion rate to second-line treatment was 39.6 % in the elderly and 72.8 % in the non-elderly. In addition, the median overall survival was 30 months (95 % CI: 25.8-37.7) in the elderly and not reached (NR) (95 % CI: NR-NR) in the non-elderly (p < 0.001).Conclusion: In a real-world clinical setting, elderly patients receiving osimertinib as first-line treatment should be aware of the frequent inability to transition to second-line treatment due to adverse events.

引用

页数：10

共 50 条

[41] Osimertinib-first or second line for epidermal growth factor (EGFR) mutation-positive non-small cell lung cancer?
Green, John A.
JOURNAL OF THORACIC DISEASE, 2018, 10 : S3837 - S3839
[42] Real-World Analysis of Post-Progression Treatment Patterns and Outcomes for EGFR Mutation-Positive Patients Treated with First-Line Osimertinib
Gibson, Amanda Jane Williams
Dean, Michelle Liane
Litt, Ishjot
Box, Adrian
Cheung, Winson Y.
Navani, Vishal
CURRENT ONCOLOGY, 2024, 31 (05) : 2427 - 2440
[43] BUDGET IMPACT ANALYSIS OF ERLOTIB AS THE FIRST-LINE THERAPY OF ADVANCED EGFR MUTATION-POSITIVE NON-SMALL CELL LUNG CANCER IN VIETNAM
Tran, T. T.
Nguyen, T.
VALUE IN HEALTH, 2016, 19 (03) : A142 - A143
[44] Real-world osimertinib for EGFR mutation-positive non-small-cell lung cancer with acquired T790M mutation
Imamura, Fumio
Kimura, Madoka
Yano, Yukihiro
Mori, Masahide
Suzuki, Hidekazu
Hirashima, Tomonori
Ihara, Shouichi
Komuta, Kiyoshi
Shiroyama, Takayuki
Nagatomo, Izumi
Kumagai, Toru
FUTURE ONCOLOGY, 2020, 16 (21) : 1537 - 1546
[45] Real-world study of dacomitinib as first-line treatment for patients with EGFR-mutant non-small cell lung cancer
Shin, J. E.
ANNALS OF ONCOLOGY, 2023, 34 : S1696 - S1697
[46] The impact of osimertinib on function and health status for patients with EGFR mutation-positive advanced non-small cell lung cancer.
Rudell, Katja
Papadakis, Konstantinos
Bodnar, Carolyn
Hoyle, Christopher
Ghiorghiu, Serban
Ryden, Anna
JOURNAL OF CLINICAL ONCOLOGY, 2016, 34 (15)
[47] Real-world, first-line Osimertinib treatment in epidermal growth factor receptor mutation-positive (EGFRm) advanced NSCLC
Griesinger, F.
Nieva, J.
Kim, Y. -H
Cohen, A.
Horvat, P.
Lu, S.
Taylor, A.
Yu, N.
Sawyer, W.
Shenolikar, R.
Shaw, S.
ONCOLOGY RESEARCH AND TREATMENT, 2021, 44 : 254 - 254
[48] Real-World, First-Line Osimertinib Treatment in Epidermal Growth Factor Receptor Mutation-Positive (EGFRm) Advanced NSCLC
Nieva, J.
Griesinger, F.
Kim, Y.
Cohen, A.
Horvat, P.
Lu, S.
Taylor, A.
Yu, N.
Sawyer, W.
Shenolikar, R.
Shaw, S.
JOURNAL OF THORACIC ONCOLOGY, 2021, 16 (03) : S616 - S617
[49] THE REAL-WORLD EFFICACY OF FIRST-LINE TYROSINE KINASE INHIBITORS IN ASIAN PATIENTS WITH EGFR MUTATION NON-SMALL CELL LUNG CANCER
Su, Vincent Yi-Fong
Yang, Kuang-Yao
Chen, Yuh-Min
RESPIROLOGY, 2018, 23 : 21 - 22
[50] First-line treatment for advanced or metastatic EGFR mutation-positive non-squamous non-small cell lung cancer: a network meta-analysis
Zhang, Mengyao
Sun, Lan
FRONTIERS IN ONCOLOGY, 2025, 14

← 1 2 3 4 5 →