Neal J, Lee JB, Ahn MJ, Ariyasu R, nash C, Smith D, Nagar S, Jimenez M, Kahangire DA, Kim YJ, Nasirova F, Lin S. Treatment (tx) patterns and clinical outcomes in unresectable stage III epidermal growth factor receptor-mutation positive (EGFRm) non-small cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT): interim analysis of a global real-world (RW) study. Poster presented at the European Lung Cancer Congress (ELCC) 2024; March 20, 2024. Prague, Czech Republic.

BACKGROUND: There is an unmet need for patients (pts) with unresectable stage III EGFRm NSCLC who receive CRT. Consolidative immunotherapy has limited efficacy and no EGFR-TKIs are approved in this setting. We report interim data from a global, retrospective RW study of pts with unresectable stage III EGFRm NSCLC who received CRT.

METHODS: Data were extracted from medical records of pts (≥18 years) with unresectable stage III EGFRm NSCLC diagnosed 1 Jan 2016–31 Dec 2019, who received CRT +/- durvalumab (durva) as standard of care (data cutoff: 31 Dec 2022) . Study outcomes were: mutation testing and tx patterns, RW progression-free survival (rwPFS), time to next tx or death (rwTTNTD) and overall survival (rwOS ).

RESULTS: Pts (N=73) from South Korea (68%), US (25%), Japan (5%) and UK (1%) had a median age of 66 years; 56% were female, 91% had ECOG PS 0–1 , 41% were current/former smokers, 92% had adenocarcinoma, 64% and 36% had EGFR Ex19del and L858R mutations, respectively . Tumour PD-L1 expression was negative , low (1–49%), high (≥50%) and unknown in 27%, 18%, 12% and 42% of pts, respectively. Overall, 89% received CRT alone and 11% received CRT + durva; 55% and 41% received concurrent or sequential CRT, respectively (4% unknown CRT sequence) . CRT comprised platinum + paclitaxel (78%), platinum + pemetrexed (11%) and platinum/other + chemotherapy (11%) . 78% of pts completed first tx, 12% discontinued due to adverse events, 16% discontinued for other reasons (of which 5% progressive disease). Of 62 pts (85%) who received a subsequent tx, 42 (68%) received EGFR-TKIs . 45 pts (62%) received a second subsequent tx (62% EGFR-TKIs ). Median rwPFS, rwTTNTD and rwOS from CRT initiation were 8.0 months (95% confidence interval [CI] 6.1, 9.5), 9.3 months (95% CI 8.0, 11.9) and 60.9 months (95% CI 44.4, 66.9 ), respectively.

CONCLUSIONS: In this analysis of pts with unresectable stage III EGFRm NSCLC receiving CRT in RW clinical practice, the majority received EGFR-TKIs as subsequent tx following CRT. Despite relatively short rwPFS, rwOS was prolonged, which may be attributed to subsequent EGFR-TKI use.