Real-World Treatment Patterns, Epidermal Growth Factor Receptor (EGFR) Testing and Outcomes in EGFR-Mutated Advanced Non-small Cell Lung Cancer Patients in Belgium: Results from the REVEAL Study

• Published in: Drugs - Real World Outcomes Vol. 8; no. 2; pp. 141 - 152
• Main Authors: Cuppens, Kristof, Lodewyckx, Liesbet, Demedts, Ingel, Decoster, Lore, Colinet, Benoît, Deschepper, Koen, Janssens, Annelies, Galdermans, Daniella, Pieters, Thierry
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2021; Springer; Springer Nature B.V
• Subjects: Antimitotic agents; Antineoplastic agents; Biopsy; Cancer therapies; Chemotherapy; Clinical medicine; Clinical outcomes; Demographics; Drug therapy; Epidermal growth factor; Internal Medicine; Lung cancer; Lung cancer, Non-small cell; Medical records; Medicine; Medicine & Public Health; Metastasis; Mutation; Observational studies; Oncology; Original; Original Research Article; Patient outcomes; Patients; Pharmacology/Toxicology; Pharmacotherapy; Testing; Belgium
• ISSN: 2199-1154; 2198-9788
• DOI: 10.1007/s40801-021-00243-w

Background Treatment of patients with epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) continues to evolve expeditiously. Objectives This retrospective study investigated real-world treatment patterns and EGFR mutation testing in patients with EGFRm advanced NSCLC in Belgium. Methods Data were extracted from medical records of adults diagnosed with EGFRm locally advanced/metastatic NSCLC between 1 September 2015 and 31 December 2017. Patients were followed retrospectively from diagnosis until 1 September 2018, end of clinical activity or death. Data on demographics, patient outcomes and disease characteristics, treatment patterns and EGFR mutation testing at diagnosis and progression were analyzed descriptively. Results A total of 141 patients were enrolled. At diagnosis, median age was 69 years, 63.1% were female, 88.7% had metastatic disease, 94.3% had adenocarcinoma histology, 76.6% had ECOG 0/1, 70.9% had common EGFR mutations and 29.1% had only rare mutations. In first line, 73.8% of patients received first/second-generation EGFR–tyrosine kinase inhibitors (1G/2G EGFR-TKIs), while 21.9% received other systemic treatments. Among 61 patients progressing on and discontinuing a first 1G/2G EGFR-TKI, 45 (73.8%) received subsequent systemic treatment while 16 (26.2%) did not; 20 (32.8%) received osimertinib. Among 65 patients progressing on a first 1G/2G EGFR-TKI, 47 (72.3%) were tested for T790M, of whom 25 (53.2%) were positive. Conclusion These real-world data from Belgium show that a substantial fraction of patients with EGFRm NSCLC do not receive 1G/2G EGFR-TKIs in first line and do not receive subsequent systemic treatment after progression on 1G/2G EGFR-TKIs. Only a third receive osimertinib upon progression on 1G/2G EGFR-TKIs. These observations should be considered in first-line treatment decisions. Trial Registration ClinicalTrials.gov: NCT03761901—December 3, 2018