Treatment After Osimertinib Discontinuation in Real-World Setting of Metastatic NSCLC

By: Victoria Kuhr, BA
Posted: Tuesday, April 26, 2022

Platinum-based chemotherapy regimens appear to be the most common subsequent line of therapy following osimertinib discontinuation, followed by the reuse of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) for treatment of patients with metastatic non–small cell lung cancer (NSCLC). Eric Wu, PhD, of Analysis Group, Boston, and colleagues observed that platinum-based chemotherapy regimens appear to be associated with high rates of inpatient and emergency department use in this patient population. These study findings were presented at the 2022 National Comprehensive Cancer Network (NCCN) Annual Conference (Abstract HSR22-154) and published in JNCCN–Journal of the National Comprehensive Cancer Network.

The study analyzed medical and pharmacy claims from the IQVIA PharMetrics Plus Database. The study included adults with medical claims indicating metastatic NSCLC diagnosis between January 2010 and September 2019 who initiated a subsequent line of therapy after discontinuing osimertinib monotherapy after November 2015.

The study included 135 patients, 64.4% of whom were female. The mean follow-up was 8.2 months. After discontinuing osimertinib, patients were most commonly treated with platinum-based chemotherapy, immunotherapy alone, and EGFR-TKI combination regimens. The most frequently used agents in the index line of therapy were carboplatin, pemetrexed, and pembrolizumab. Reuse of osimertinib as a monotherapy or combination therapy occurred in 17 patients (12.6%). Overall, the median time of discontinuation for the index line of therapy was 2.4 months, and the median time to the next treatment was 5.3 months. The proportions of patients with more than one inpatient admission or emergency department visit while on the index line of therapy were 31.9% and 35.6%, respectively. The mean number of inpatient admissions and emergency department days were 15.9 and 20.0 per 100 patient-months, respectively.

Disclosure: Two study authors are employed by Daiichi Sankyo, and Dr. Wu and three other coauthors are employed by a consulting company that has received research grants from Daiichi Sankyo to conduct this study.

JNCCN–Journal of the National Comprehensive Cancer Network

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