Marrett Elizabeth, Kwong Winghan Jacqueline, Song Jinlin, Manceur Ameur, Sendhill Selvam, Wu Eric
Health Economic and Outcomes Research, Daiichi Sankyo, Inc., 211 Mount Airy Road, Basking Ridge, NJ, 07920, USA.
Analysis Group, Los Angeles, CA, USA.
Oncol Ther. 2024 Sep;12(3):549-563. doi: 10.1007/s40487-024-00292-5. Epub 2024 Jul 30.
Current treatment guidelines for patients with epidermal growth factor receptor (EGFR)-mutated metastatic non-small cell lung cancer (mNSCLC) recommend EGFR tyrosine kinase inhibitors (TKIs) as the standard of care for first-line treatment, with third-generation osimertinib the preferred choice. However, most patients develop resistance to targeted therapy, and subsequent systemic chemotherapy is recommended. The aim of this study was to characterize the subsequent line of therapy (LOT) following osimertinib in patients with EGFR-mNSCLC.
Medical and pharmacy claims of adults who initiated a subsequent LOT (index) after initial osimertinib discontinuation between November 2015 and September 2019 were analyzed retrospectively.
A total of 135 patients met the inclusion criteria. After metastatic diagnosis, 22.2% and 49.6% of patients were treated with osimertinib in the first and second line, respectively. After osimertinib discontinuation, most patients were treated with a platinum-based chemotherapy regimen (57%), of which 40.3% included immuno-oncology therapy. Reuse or continuation of EGFR TKIs was also common (24%). Overall, the median time to treatment discontinuation for the index LOT was 2.4 months. Proportions of patients with ≥ 1 inpatient or emergency department visit were 31.9% and 35.6%, respectively.
The duration of the LOT following osimertinib was short and associated with tolerability issues underscoring a high unmet need for new therapies to address EGFR TKI resistance.
表皮生长因子受体（EGFR）突变的转移性非小细胞肺癌（mNSCLC）患者的当前治疗指南推荐EGFR酪氨酸激酶抑制剂（TKIs）作为一线治疗的标准治疗方法，第三代奥希替尼为首选。然而，大多数患者会对靶向治疗产生耐药性，随后建议进行全身化疗。本研究的目的是描述EGFR-mNSCLC患者在使用奥希替尼后的后续治疗方案（LOT）。
回顾性分析了2015年11月至2019年9月期间在首次停用奥希替尼后开始后续LOT（索引）的成年人的医疗和药房索赔记录。
共有135名患者符合纳入标准。在转移诊断后，分别有22.2%和49.6%的患者在一线和二线接受了奥希替尼治疗。在停用奥希替尼后，大多数患者接受了铂类化疗方案（57%），其中40.3%包括免疫肿瘤治疗。EGFR TKIs的重新使用或继续使用也很常见（24%）。总体而言，索引LOT的中位治疗中断时间为2.4个月。有≥1次住院或急诊就诊的患者比例分别为31.9%和35.6%。
奥希替尼之后的LOT持续时间较短，且与耐受性问题相关，这突出表明迫切需要新的疗法来解决EGFR TKI耐药性问题。
