BACKGROUND: In LAURA (NCT03521154), osimertinib after definitive CRT demonstrated statistically significant and clinically meaningful progression-free survival (PFS) benefit in pts with UR stg III EGFRm NSCLC (PFS HR [95% CI], 0.16 [0.10, 0.24]; p<0.001). It is important to understand rw Tx patterns/clinical outcomes in this setting to measure the impact of new Txs. We report final results from a global, retrospective, rw study in pts with UR stg III EGFRm NSCLC who received CRT as SoC.
METHODS: Data were extracted from records of adult pts with UR stg III EGFRm (Ex19del/L858R) NSCLC diagnosed Jan 2016–Dec 2019 who received CRT as SoC. Primary endpoint: rwPFS. Secondary endpoints: mutation testing and Tx patterns, rw time to next Tx or death (rwTTNTD), rw overall survival (rwOS). DCO: 31 Dec 2022.
RESULTS: Overall, 172 pts from South Korea (30%), Japan (30%), USA (20%), Taiwan (15%), UK (5%) and Austria (1%) with UR stg III EGFRm (Ex19del, 59%/L858R, 41%) NSCLC were enrolled; median age, 67 yrs; ECOG PS 0/1, 91%; current/former smokers, 37%. Among 112 (65%) and 42 (24%) pts who received concurrent or sequential CRT (10% unknown), the most common chemotherapy regimens were carboplatin + paclitaxel and cisplatin + paclitaxel (29/154; 19% each). In total, 134 (78%), 31 (18%) and 6 (3%) patients, respectively, received CRT alone, CRT + durvalumab and CRT + EGFR-TKI as first Tx; EGFR-TKIs were the most common first subsequent Tx (86/115; 75%). In pts who received CRT alone, median (95% CI) rwPFS, rwTTNTD and rwOS were 6.7 (5.4, 9.0), 11.0 (9.0, 14.3) and 68.6 (60.9, NE) months, respectively (Table).
CONCLUSIONS: In this global rw analysis of pts with UR stg III EGFRm NSCLC, most pts received CRT alone as first Tx; most common subsequent Tx was EGFR-TKIs. In pts who received CRT alone, rwPFS was consistent with prior studies ; rwOS was substantial despite relatively short rwPFS, which may be attributable to subsequent EGFR-TKIs.
