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Found 1 Presentation For Request "miura"

Advanced NSCLC

145P - UpSwinG: real-world, non-interventional cohort study on TKI activity in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC with uncommon mutations

Room
ePoster Display
Speakers
  • S. Miura (Niigata, Japan)
Authors
  • S. Miura (Niigata, Japan)
  • T. Hsia (Taichung, Taiwan)
  • J. Hung (Kaohsiung, Taiwan)
  • H. Jung (Seoul, Korea, Republic of)
  • J. Shih (Taipei, Taiwan)
  • T. Yang (Taipei, Taiwan)
  • C. Park (Hwasun, Korea, Republic of)
  • S. Lee (Seoul, Korea, Republic of)
  • T. Okamoto (Fukuoka, Japan)
  • H. Ahn (Incheon, Korea, Republic of)
  • Y. Lee (Jeonju, Korea, Republic of)
  • Y. Sato (Hyogo, Japan)
  • S. Lee (Busan, Korea, Republic of)
  • C. Mascaux (Strasbourg, France)
  • H. Daoud (Ingelheim am Rhein, Germany)
  • A. Märten (Ingelheim am Rhein, Germany)
  • S. Popat (London, United Kingdom)

Abstract

Background

EGFR TKIs are established as an effective treatment (tx) option for pts with EGFRm+ NSCLC with common (Del19 or L858R) mutations, but limited clinical data exist for EGFR TKI use in the 7–23% of NSCLC tumours with uncommon EGFR mutations.

Methods

In this non-interventional, global, multi-centre study (NCT04179890), existing medical or electronic health records were identified for consecutive EGFR TKI-naïve pts with uncommon EGFR mutations treated with either erlotinib, gefitinib, afatinib or osimertinib. Endpoints included time to tx failure (TTF), ORR, OS and duration of response (DoR).

Results

Pts (n = 246; median age: 69.5 yrs; brain metastases: 7%; ECOG PS ≥2: 16%; Asian: 84%) were recruited from 9 countries. Uncommon mutation categories were: major uncommon (G719X, L861Q, S768I; 73%); compound (35%); ex20ins (12%); T790M (7%); other (9%). Most pts (n = 226; 92%) were treated in 1st-line with an EGFR TKI; 132 (54%), 70 (28%), 35 (14%) and 7 (3%) received afatinib, gefitinib, erlotinib and osimertinib. 57% of pts received >1 line of therapy. Mutations were detected using PCR (75%) or sequencing (25%), mainly based on tissue biopsy (86%). Pathology reports varied in quality, often lacking detail on specific mutations, e.g. ‘ex18’ or ‘ex20ins’. Overall, median TTF with an EGFR TKI was 9.9 mos; afatinib: 11.3 mos; gefitinib: 9.2 mos; erlotinib: 8.2 mos. Overall median OS was 24.4 mos. In pts with major uncommon mutations, median TTF was 14.3 and 9.8 mos with afatinib and 1st-gen TKIs. Median TTF in pts receiving 1st-line chemotherapy was only 4.0 mos. ORR was 42% overall (major: 50%; compound: 49%; other: 44%; T790M: 20%; ex20ins: 17%); afatinib: 44% (DoR: 12.0 mos); 1st-gen TKIs: 44% (DoR: 11.0 mos). More detailed analysis will be presented at the conference.

Conclusions

EGFR TKIs were the preferred tx option in pts with uncommon EGFR mutations. Response was highest in pts with major uncommon, and/or compound mutations. Data were in line with recent analyses of afatinib in uncommon mutations. Tx with an EGFR TKI should be considered as standard for pts with uncommon mutations, although many ex20ins were not responsive. To inform optimal tx choice, specific details of EGFR mutations must be reported.

Clinical trial identification

NCT04179890, first posted November 27, 2019.

Editorial acknowledgement

Medical writing assistance, supported financially by Boehringer Ingelheim, was provided by Steven Kirkham, of GeoMed, an Ashfield company, part of UDG Healthcare plc, during the development of this abstract.

Legal entity responsible for the study

Boehringer Ingelheim.

Funding

Boehringer Ingelheim.

Disclosure

S. Miura: Speaker Bureau/Expert testimony: Boehringer Ingelheim Inc.; Speaker Bureau/Expert testimony: MSD Inc.; Speaker Bureau/Expert testimony: Elli Lilly Japan; Speaker Bureau/Expert testimony: Ono Pharma. Inc; Speaker Bureau/Expert testimony: Chugai Pharm Inc. J-Y. Shih: Honoraria (self): AstraZeneca; Honoraria (self), Research grant/Funding (self): Roche; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Eli Lilly; Honoraria (self): Pfizer; Honoraria (self): Novartis; Honoraria (self): Merck Sharp & Dohme; Honoraria (self): Ono Pharmaceutical; Honoraria (self): Chugai; Honoraria (self): Bristol-Myers Squibb. T. Okamoto: Honoraria (self): AstraZeneca; Honoraria (self), Research grant/Funding (institution): Eli Lilly Japan; Honoraria (self): Johnson & Johnson; Honoraria (self), Research grant/Funding (institution): MSD; Honoraria (self), Research grant/Funding (institution): Nippon Boehringer Ingelheim; Honoraria (self), Research grant/Funding (institution): Taiho Pharmaceutical; Research grant/Funding (institution): Chugai Pharmaceutical; Research grant/Funding (institution): Covidien Japan; Research grant/Funding (institution): Novartis Pharma; Research grant/Funding (institution): Ono Pharmaceutical; Research grant/Funding (institution): Pfizer Japan. H.K. Ahn: Speaker Bureau/Expert testimony: AstraZeneca; Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Lilly. Y. Sato: Honoraria (self): Chugai Phama; Honoraria (self): MSD; Honoraria (self): Ono Pharmaceutical CO; Honoraria (self): Novartis; Honoraria (self): Taiho Pharmaceutical; Honoraria (self): AstraZeneca; Honoraria (self): Nippon Kayaku. C. Mascaux: Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self): Kephren; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Merck Sharp & Dohme; Honoraria (self): Pfizer; Travel/Accommodation/Expenses: Boehringer Ingelheim; Travel/Accommodation/Expenses: Takeda. H. Daoud: Full/Part-time employment: Boehringer Ingelheim International GmbH. A. Märten: Full/Part-time employment: Boehringer Ingelheim. S. Popat: Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Roche; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Boehringer Ingelheim; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Pfizer; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Novartis; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Takeda; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: BMS; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: MSD; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: EMD Serono; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Bayer; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Blueprint; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Daiichi Sankyo; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Guardant Health; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: Janssen; Advisory/Consultancy, Research grant/Funding (institution), Consulting fees and Corporate-sponsored research: GSK; Advisory/Consultancy, Consulting fees: BeiGene; Advisory/Consultancy, Consulting fees: Incyte; Advisory/Consultancy, Consulting fees: Eli Lilly; Advisory/Consultancy, Consulting fees: Amgen; Research grant/Funding (institution), Corporate-sponsored research: Ariad; Research grant/Funding (institution), Corporate-sponsored research: Clovis; Research grant/Funding (institution), Corporate-sponsored research: Celgene; Research grant/Funding (institution), Corporate-sponsored research: Epizyme; Research grant/Funding (institution), Corporate-sponsored research: Mirati; Research grant/Funding (institution), Corporate-sponsored research: Trizel; Research grant/Funding (institution), Corporate-sponsored research: Turning Point Therapeutics. All other authors have declared no conflicts of interest.

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