Is osimertinib an effective treatment for EGFR-mutant advanced non-small cell lung cancer in a real-world practice?

This study looked at the use of osimertinib (Tagrisso) for the treatment of EGFR-mutant advanced non-small-cell lung cancer (NSCLC) in a real-world practice. It found that osimertinib was confirmed to improve survival without cancer progressing, while the occurrence of blood clots was more common in a real-world practice.

Advanced NSCLC describes lung cancer that has spread to other parts of the body, typically the lymph nodes, brain, bones, liver, or adrenal glands. EGFR is a protein found on the surface of normal cells in the body. EGFR-mutant is an abnormal form of this protein that can be associated with lung cancer. 10-15% of NSCLCs are caused by this mutation. Targeted therapies that block this mutation such as erlotinib (Tarceva) and gefitinib (Iressa) are used for the treatment of EGFR-mutant NSCLC. 

Osimertinib is a newer generation of EGFR-targeted therapy that is approved for the treatment of advanced EGFR-mutant NSCLC. It has proven to be safe and effective for these patients in clinical trials. However, in clinical trials patients are commonly young and fit. Therefore, it is unclear if it is safe and effective in a real-world population that also has older patients and who have other medical conditions.

126 patients with advanced NSCLC from 9 cancer centers participated in this study. 30.2% of patients had cancer which had spread to the brain. All patients were treated with osimertinib 80 mg daily. Patients were followed up for an average of 12.3 months.

On average, patients did not show signs of cancer progression for 18.9 months. Overall, 73% of patients responded to treatment. 96% of patients had stable disease (cancer shrank or did not progress).

Overall, 87% of patients had side effects. 33% of patients had serious side effects, the most common of which was blood clots (7.9%).

This study showed that osimertinib is an effective treatment for advanced EGFR-mutant NSCLC in a real-world setting. However, it may be associated with a higher risk of blood clots compared to clinical trials.

This study involved caucasian patients only, more studies are needed to see if these findings apply to other ethnicities.