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Research ArticleOpen Accesscc iconby iconnc iconnd icon

Real-world osimertinib for EGFR mutation-positive non-small-cell lung cancer with acquired T790M mutation

    Fumio Imamura

    *Author for correspondence:

    E-mail Address: fimam@d6.dion.ne.jp

    Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan

    ,
    Madoka Kimura

    Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan

    ,
    Yukihiro Yano

    Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan

    ,
    Masahide Mori

    Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan

    ,
    Hidekazu Suzuki

    Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino, Osaka, 583-8588, Japan

    ,
    Tomonori Hirashima

    Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino, Osaka, 583-8588, Japan

    ,
    Shouichi Ihara

    Department of Respirology, Osaka Police Hospital, 2-6-40 Karasugatsuji, Tenoji-ku, Osaka, 543-8922, Japan

    ,
    Kiyoshi Komuta

    Department of Respirology, Osaka Police Hospital, 2-6-40 Karasugatsuji, Tenoji-ku, Osaka, 543-8922, Japan

    ,
    Takayuki Shiroyama

    Department of Respiratory Medicine & Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    ,
    Izumi Nagatomo

    Department of Respiratory Medicine & Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    &
    Toru Kumagai

    Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan

    Published Online:https://doi.org/10.2217/fon-2020-0203

    Aim: Osimertinib is a key drug for EGFR mutation-positive non-small-cell lung cancer (NSCLC). As the hazards ratio of overall survival in comparison with first-generation EGFR-tyrosine kinase inhibitors was almost similar between FLAURA and ARCHER 1050, salvage use of osimertinib is still a treatment option. Patients & methods: We retrospectively analyzed the clinical courses of EGFR mutation-positive NSCLC patients who were potential candidates for salvage osimertinib. Results: Among 524 patients enrolled from five hospitals, 302 patients underwent biopsy, with 52.6% detection rate of T790M. Osimertinib was administered in 93.6% of the T790M-positive patients. The overall response rate and median progression-free survival time of osimertinib were calculated with 147 patients, to be 55.6% and 17.2 months, respectively. Conclusion: Osimertinib is active for T790M-driven acquired resistance in EGFR-mutant NSCLC, but the detection of T790M was unsatisfactory.

    Clinical Trial Registration: UMIN000028989 (UMIN Clinical Trials Registry)

    Papers of special note have been highlighted as: • of interest

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