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Abstract：
BACKGROUND: Current treatment guidelines for patients with epidermal growth factor receptor (EGFR)-mutated metastatic non-small cell lung cancer (mNSCLC) recommend EGFR tyrosine kinase inhibitors (TKIs) as the standard of care for first-line treatment, with third-generation osimertinib the preferred choice. However, most patients develop resistance to targeted therapy, and subsequent systemic chemotherapy is recommended. The aim of this study was to characterize the subsequent line of therapy (LOT) following osimertinib in patients with EGFR-mNSCLC.
METHODS: Medical and pharmacy claims of adults who initiated a subsequent LOT (index) after initial osimertinib discontinuation between November 2015 and September 2019 were analyzed retrospectively.
RESULTS: A total of 135 patients met the inclusion criteria. After metastatic diagnosis, 22.2% and 49.6% of patients were treated with osimertinib in the first and second line, respectively. After osimertinib discontinuation, most patients were treated with a platinum-based chemotherapy regimen (57%), of which 40.3% included immuno-oncology therapy. Reuse or continuation of EGFR TKIs was also common (24%). Overall, the median time to treatment discontinuation for the index LOT was 2.4 months. Proportions of patients with ≥ 1 inpatient or emergency department visit were 31.9% and 35.6%, respectively.
CONCLUSIONS: The duration of the LOT following osimertinib was short and associated with tolerability issues underscoring a high unmet need for new therapies to address EGFR TKI resistance.
METHODS: Medical and pharmacy claims of adults who initiated a subsequent LOT (index) after initial osimertinib discontinuation between November 2015 and September 2019 were analyzed retrospectively.
RESULTS: A total of 135 patients met the inclusion criteria. After metastatic diagnosis, 22.2% and 49.6% of patients were treated with osimertinib in the first and second line, respectively. After osimertinib discontinuation, most patients were treated with a platinum-based chemotherapy regimen (57%), of which 40.3% included immuno-oncology therapy. Reuse or continuation of EGFR TKIs was also common (24%). Overall, the median time to treatment discontinuation for the index LOT was 2.4 months. Proportions of patients with ≥ 1 inpatient or emergency department visit were 31.9% and 35.6%, respectively.
CONCLUSIONS: The duration of the LOT following osimertinib was short and associated with tolerability issues underscoring a high unmet need for new therapies to address EGFR TKI resistance.
摘要：
背景：目前针对表皮生长因子受体（EGFR）突变的转移性非小细胞肺癌（mNSCLC）患者的治疗指南推荐EGFR酪氨酸激酶抑制剂（TKIs）作为一线治疗的标准。以第三代奥希替尼为首选。然而,大多数患者对靶向治疗产生抵抗，建议随后进行全身化疗。这项研究的目的是表征EGFR-mNSCLC患者在奥希替尼后的后续治疗路线（LOT）。
方法：对在2015年11月至2019年9月期间首次停用奥希替尼后开始后续LOT（指数）的成年人的医疗和药学索赔进行回顾性分析。
结果：共有135例患者符合纳入标准。转移性诊断后,22.2％和49.6％的患者在一线和二线接受奥希替尼治疗，分别。奥希替尼停药后，大多数患者接受以铂类为基础的化疗方案(57%)，其中40.3%包括免疫肿瘤学治疗。EGFRTKI的重复使用或继续使用也很常见（24％）。总的来说,指数LOT的中位停药时间为2.4个月.住院或急诊科就诊≥1次的患者比例分别为31.9%和35.6%，分别。
结论：奥希替尼治疗后LOT的持续时间较短，并且与耐受性问题相关，这突显了对解决EGFRTKI耐药的新疗法的高度未满足需求。
方法：对在2015年11月至2019年9月期间首次停用奥希替尼后开始后续LOT（指数）的成年人的医疗和药学索赔进行回顾性分析。
结果：共有135例患者符合纳入标准。转移性诊断后,22.2％和49.6％的患者在一线和二线接受奥希替尼治疗，分别。奥希替尼停药后，大多数患者接受以铂类为基础的化疗方案(57%)，其中40.3%包括免疫肿瘤学治疗。EGFRTKI的重复使用或继续使用也很常见（24％）。总的来说,指数LOT的中位停药时间为2.4个月.住院或急诊科就诊≥1次的患者比例分别为31.9%和35.6%，分别。
结论：奥希替尼治疗后LOT的持续时间较短，并且与耐受性问题相关，这突显了对解决EGFRTKI耐药的新疗法的高度未满足需求。
