Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Center for Lung Cancer, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2020 Jan;52(1):284-291. doi: 10.4143/crt.2019.200. Epub 2019 Jul 23.
Osimertinib is a third-generation, irreversible, oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that potently and selectively inhibits both EGFR sensitizing mutation and EGFR T790M and has demonstrated efficacy in non-small cell lung cancer (NSCLC) central nervous system (CNS) metastases. We present results of a subgroup analysis of Korean patients from the pooled data of two global phase II trials: AURA extension (NCT01802632) and AURA2 (NCT02094261).
Enrolled patients had EGFR T790M-positive NSCLC and disease progression during or after EGFR-TKI therapy. Patients received osimertinib 80 mg orally once daily until disease progression. The primary endpoint was objective response rate (ORR).
In total, 66 Korean patients received osimertinib treatment with a median treatment duration of 19 months. In the evaluable-for-response population (n=62), ORR was 74% (95% confidence interval [CI], 61.5 to 84.5) and median duration of response was 9.8 months (95% CI, 7.1 to 16.8). In the full analysis set (n=66), median progression-free survival was 10.9 months (95% CI, 8.3 to 15.0; data cutoff November 1, 2016), and median overall survival was 29.2 months (95% CI, 24.8 to 35.7; data cutoff May 1, 2018). Eight patients with CNS metastases were evaluable for response, none of whom showed CNS progression. The most common adverse events were rash (53%), cough (33%), paronychia, diarrhea, and decreased appetite (each 32%).
Efficacy and safety profiles of osimertinib in this subgroup are consistent with the global phase II pooled population, which supports osimertinib as a recommended treatment for Korean patients with T790M positive NSCLC.
奥希替尼是一种第三代、不可逆的、口服表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI),能够强效和选择性地抑制 EGFR 敏感突变和 EGFR T790M,在非小细胞肺癌(NSCLC)中枢神经系统(CNS)转移中显示出疗效。我们报告了来自两项全球 II 期试验(AURA 扩展[NCT01802632]和 AURA2[NCT02094261])的汇总数据中韩国患者的亚组分析结果。
入组患者患有 EGFR T790M 阳性 NSCLC,并且在 EGFR-TKI 治疗期间或之后疾病进展。患者接受奥希替尼 80 mg 口服,每日一次,直至疾病进展。主要终点是客观缓解率(ORR)。
共有 66 名韩国患者接受奥希替尼治疗,中位治疗时间为 19 个月。在可评估反应人群(n=62)中,ORR 为 74%(95%置信区间[CI],61.5 至 84.5),中位缓解持续时间为 9.8 个月(95%CI,7.1 至 16.8)。在全分析集(n=66)中,中位无进展生存期为 10.9 个月(95%CI,8.3 至 15.0;数据截止日期为 2016 年 11 月 1 日),中位总生存期为 29.2 个月(95%CI,24.8 至 35.7;数据截止日期为 2018 年 5 月 1 日)。8 名有 CNS 转移的患者可评估反应,无 1 例出现 CNS 进展。最常见的不良反应是皮疹(53%)、咳嗽(33%)、甲沟炎、腹泻和食欲下降(各 32%)。
奥希替尼在该亚组中的疗效和安全性特征与全球 II 期汇总人群一致,支持奥希替尼作为 T790M 阳性 NSCLC 韩国患者的推荐治疗药物。