Real-world treatment patterns of patients with EGFR exon 20 insertion-mutated advanced NSCLC treated with amivantamab or mobocertinib after platinum-based chemotherapy: A multi-database cohort study.

OBJECTIVE

To describe characteristics, treatment patterns, and outcomes of patients with EGFR exon 20 insertion (exon20ins)-positive advanced or metastatic non-small cell lung cancer (NSCLC) who received amivantamab or mobocertinib monotherapy after platinum-based chemotherapy (PBC).

PATIENTS AND METHODS

This retrospective longitudinal cohort study pooled electronic health records from the Flatiron Health (January 2011-August 2022), Ontada (January 2013-January 2023), and COTA (January 2010-December 2022) databases. Patients (≥20 years) with advanced or metastatic EGFR exon20ins NSCLC who received amivantamab or mobocertinib following PBC were included. Patient characteristics and treatment patterns were analyzed descriptively. Time to next treatment or death (TTNTD) and time to discontinuation (TTD) were assessed using Kaplan-Meier estimates.

RESULTS

44 patients treated with amivantamab and 24 patients with mobocertinib after PBC met the selection criteria. Patient characteristics were consistent with previous studies. Most patients received amivantamab or mobocertinib as second-line (57 % and 50 %) or third-line (32 % and 33 %) therapy. The median TTNTD was 9.2 months for amivantamab and 4.2 months for mobocertinib. Fewer patients in the amivantamab cohort (43 %) experienced a TTNTD event than the mobocertinib cohort (63 %). The median TTD was 8.6 months for amivantamab and 2.3 months for mobocertinib, with a lower discontinuation rate in the amivantamab cohort (46 % vs 67 %).

CONCLUSION

Real-world patients with EGFR exon20ins NSCLC treated with amivantamab after PBC experienced median TTNTD and TTD consistent with the median progression-free survival observed in its registrational trial while patients treated with mobocertinib exhibited faster disease progression and a higher frequency of treatment discontinuation.

MICROABSTRACT

This retrospective study described patient characteristics, treatment patterns, and outcomes in patients with EGFR exon20ins-mutated advanced or metastatic NSCLC who received amivantamab or mobocertinib monotherapy after platinum-based chemotherapy. Real-world patients treated with amivantamab experienced TTNTD and TTD consistent with the median progression-free survival observed in its registrational trial, while patients treated with mobocertinib exhibited faster disease progression and a higher frequency of treatment discontinuation.