Real-world Treatment Patterns in Patients with EGFR Mutation-positive NSCLC Receiving a First-Line, First- or Second-generation EGFR Tyrosine Kinase Inhibitor in South Korea and Taiwan

Authors

  • Jae Cheol Lee Department of Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
  • Jen-Yu Hung Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
  • Young-Chul Kim Department of Internal Medicine, Chonnam National University Medical School and Lung Cancer Clinic, Pulmonary Medicine, Chonnam National University Hwasun Hospital, Jeonnam, Korea
  • Gee-Chen Chang Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Seung Soo Yoo Lung Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • Sheng-Hsiung Yang Mackay Memorial Hospital, Taipei, Taiwan
  • Keith L Davis Health Economics Group, RTI Health Solutions, Research Triangle Park, Durham, NC, USA
  • Saurabh P Nagar Health Economics Group, RTI Health Solutions, Research Triangle Park, Durham, NC, USA
  • Aliki Taylor Oncology Business Unit, AstraZeneca, Cambridge, UK
  • Sung Yong Lee Pulmonology, Allergy and Critical Care Medicine, Korea University Guro Hospital, Seoul, Korea
  • Jin-Yuan Shih Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan

Keywords:

EGFR mutation, EGFR-TKI, NSCLC, osimertinib, T790M

Abstract

Introduction: The preferred first-line (1L) treatment for epidermal growth factor receptor (EGFR) mutation-positive (EGFRm) advanced/metastatic non-small lung cancer (NSCLC) are EGFR-tyrosine kinase inhibitors (TKIs). However, most patients treated with 1L first- or second-generation (1G/2G) EGFR-TKIs acquire resistance; the EGFR T790M mutation is observed in ~30–50% of patients. We report real-world NSCLC treatment and T790M testing patterns in South Korea and Taiwan.
Methods: Retrospective medical record review of EGFRm advanced/metastatic NSCLC patients from routine practice. 1G/2G EGFR-TKI initiation 1 January 2015–31 December 2017 (follow-up end date: last available medical record or August 2019). Study measures: demographic/disease characteristics, 1L/2L treatment, T790M testing.
Results: In South Korea, 70% (164/235) and in Taiwan 89% (89/100) experienced 1L disease progression (median [range] follow-up: 22 [2.3–50.7] months). Of those with disease progression, 68% (111/164) and 62% (55/89) had T790M testing in South Korea and Taiwan, respectively. In South Korea, 43% (48/111) were T790M-positive with 88% (n=42/48) receiving osimertinib (mostly 2L). In Taiwan, 18% (10/55) were T790M-positive; 100% received osimertinib. Overall, 73% (120/164) and 63% (63/100) in South Korea and Taiwan, respectively, received 2L therapy, predominantly pemetrexed-containing regimens. Among patients with disease progression, 9% (14/164) and 24% (21/89) died before receiving 2L therapy in South Korea and Taiwan, respectively.
Conclusion: In both countries, <70% with 1L disease progression were tested for T790M at any point from NSCLC diagnosis, suggesting resistance mutation testing could be improved. Treatment/testing patterns may have changed in both countries since study initiation due to osimertinib reimbursement changes beginning December 2017.

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Published

2021-05-20

Issue

Vol. 6 No. 2 (2021)

Section

Research Articles/ Original Work

License

 West Asia Organization for Cabcer Prevention retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License 4 (This permits anyone to copy, distribute, transmit and adapt the published work, provided the original work and source are appropriately cited).