Efficacy of osimertinib in patients with EGFR‐mutation positive non‐small cell lung cancer with malignant pleural effusion

Author:

Kiritani Ayu12,Amino Yoshiaki2ORCID,Uchibori Ken2ORCID,Akita Takahiro23,Harutani Yuhei24,Ogusu Shinsuke25,Tsugitomi Ryosuke2,Manabe Ryo26,Ariyasu Ryo2ORCID,Kitazono Satoru2,Yanagitani Noriko2,Nishio Makoto2ORCID

Affiliation:

1. Department of Respiratory Medicine Jikei University School of Medicine Minato Japan

2. Department of Thoracic Medical Oncology Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto Japan

3. Department of Respiratory Medicine Hachinohe City Hospital Hachinohe Japan

4. Department of Internal Medicine III Wakayama Medical University Wakayama Japan

5. Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine Faculty of Medicine, Saga University Saga Japan

6. Division of Allergology and Respiratory Medicine, Department of Internal Medicine Showa University School of Medicine Shinagawa Japan

Abstract

AbstractBackgroundAs an epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI), osimertinib has emerged as a standard EGFR‐mutation positive treatment for non‐small cell lung cancer (NSCLC). However, the efficacy of osimertinib for malignant pleural effusion (MPE) remains understudied. This study aimed to evaluate the impact of osimertinib on time to treatment failure (TTF) and overall survival (OS) in patients with EGFR‐mutation positive NSCLC, comparing those with and without MPE.MethodsThis retrospective analysis included patients with advanced or recurrent NSCLC treated with osimertinib at our hospital between April 2016 and June 2021. TTF was defined as the duration from osimertinib initiation to discontinuation, and OS as the duration until death, irrespective of the reason.ResultsAmong 229 patients receiving osimertinib, 84 had MPE before administration, 39 acquired EGFR exon20 T790M mutation following previous EGFR‐TKI therapy, and 45 were EGFR‐TKI‐naive. Among EGFR‐TKI‐naive patients, median TTF was 14.8 and 19.8 months for those with and without MPE, respectively (hazard ratio [HR] 1.40; 95% confidence interval [CI]: 0.90–2.18; p = 0.12). Median OS was 32.0 and 42.0 months for patients with and without MPE, respectively (HR 1.43; 95% CI: 0.86–2.38; p = 0.16). Among patients with T790M mutation, median TTF was 12.3 and 13.1 months for patients with and without MPE, respectively (HR 1.03; 95% CI: 0.69–1.55; p = 0.88). Median OS for patients with and without MPE was 23.2 and 24.7 months, respectively (HR 1.09; 95% CI: 0.72–1.67; p = 0.68).ConclusionAmong patients with EGFR‐mutation positive NSCLC, the evidence of MPE has little effect on survival with osimertinib.

Publisher

Wiley

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