Shih JY, Lin SH, Nagar SP, Davis KL, Jimenez MI, Kahangire DA, Servidio L, Ho L, Veluswamy R. Treatment patterns in resectable early-stage NSCLC in Taiwan: subgroup analysis of a global real-world study. Poster presented at the 2022 ESMO Asia Congress; December 2, 2022. Singapore, Republic of Singapor.

BACKGROUND: Complete surgical resection is the recommended treatment for early-stage NSCLC, followed by adjuvant chemotherapy for patient (pts) with resectable stage II–IIIA and select stage IB disease; however, many pts will experience disease recurrence within five yrs post-surgery. Osimertinib, an EGFR-tyrosine kinase inhibitor (EGFR-TKI), is approved as adjuvant therapy for pts with resected stage IB–IIIA EGFR mutated (EGFRm) NSCLC based on results from the Phase III ADAURA trial. We conducted a global, non-interventional study in pts with resectable NSCLC and EGFR test results available to better understand RW EGFRm frequency, treatment practices and recurrence. Interim global results were previously published; here, we report final data from pts from Taiwan.

METHODS: [293] This retrospective medical record review included adults with completely resected stage IA–IIIA NSCLC diagnosed between Jan 1, 2014 and Dec 31, 2017 and followed to Dec 31, 2020, with EGFR test results available.  Primary objectives included description of EGFRm frequency, treatment patterns (including surgical procedures) and recurrence.

RESULTS: [649] Of 200 pts enrolled in Taiwan, median age was 62 yrs (36–86 range) and 61% were female. 139 pts (70%) had EGFRm NSCLC  and 61 (31%) EGFR wild-type (EGFRwt); IA/IB/IIA/IIB/IIIA disease stage at diagnosis was 31/37/13/3/17% vs 48/16/5/11/20%, respectively. The most common first surgical resection procedures were lobectomy    (84% EGFRm vs 61% EGFRwt), wedge resection (19% vs 39%) and segmentectomy (8% vs 5%).  Neoadjuvant treatment only was received by 5% EGFRm vs 2% EGFRwt    and 43% vs 38% received adjuvant treatment only; chemotherapy was most common adjuvant treatment in both groups (55/60 [92%] vs 23/23 [100%], respectively). Overall, 43 pts (22%) had disease recurrence  at any point following initial complete surgical resection at the time of stage IA-IIIA diagnosis; the most common sites of first recurrence were lung (42%), lymph nodes (23%) and brain (21%). 

CONCLUSION: [285] In this RW study of pts from Taiwan with surgically resected early-stage NSCLC who had an EGFR test result, 70% had EGFRm. The rates of EGFRm in this RW study reinforces the need for EGFR testing in early-stage NSCLC to identify pts who may benefit from EGFR-targeted therapy to help optimize clinical outcomes by reducing risk of recurrence.

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