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Targeted Oncology
Published in: Targeted Oncology 4/2018

01-08-2018 | Short Communication

Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors

Authors: Karima Saboundji, Jean-Bernard Auliac, Maurice Pérol, Géraldine François, Henri Janicot, Marie Marcq, Catherine Dubos-Arvis, Aldo Renault, Florian Guisier, Luc Odier, Radj Gervais, Christos Chouaïd

Published in: Targeted Oncology | Issue 4/2018

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Abstract

Background

The prognosis of patients with non-small cell lung cancer (NSCLC) who develop leptomeningeal metastasis (LM) is poor.

Objective

To assess the clinical efficacy of osimertinib, a third-generation tyrosine-kinase inhibitor (TKI), in patients with epidermal growth-factor receptor (EGFR)-mutated NSCLCs and LM.

Patients and Methods

Retrospective study of NSCLC patients with osimertinib-treated EGFR-mutated NSCLC and LM.

Results

Twenty patients (mean age, 61.2 years; 70% women) with adenocarcinoma NSCLC were included in the study. EGFR mutations were reported in exons 18 (n = 2), 19 (n = 7), and 21 (n = 11). Before starting osimertinib, patients had received a mean of 2.3 treatment lines. When LM was diagnosed, all patients had clinical symptoms. Sixteen (80%) patients had a performance status ≥2. At osimertinib initiation, 13 (65%) patients harbored the EGFR-T790M–resistance mutation. Osimertinib was started at 80 (n = 17), 160 (n = 2), or 40 mg/day (n = 1). All 13 (100%) patients with the T790M mutation and 4 (57%) of those without it obtained clinical responses. Among the 11 radiologically assessable patients, 9 (82%) responded, with 5 responses reported within 15 days after treatment initiation. Median overall survival and progression-free survival were 18.0 and 17.2 months, respectively, from the start of osimertinib.

Conclusions

In this non-selected population, osimertinib had remarkable efficacy in NSCLC patients with LM irrespective of the presence of the EGFR-T790M–resistance mutation. Osimertinib efficacy was rapid in several patients, even some with poor performance status.
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Metadata
Title
Efficacy of Osimertinib in EGFR-Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with EGFR-Tyrosine Kinase Inhibitors
Authors
Karima Saboundji
Jean-Bernard Auliac
Maurice Pérol
Géraldine François
Henri Janicot
Marie Marcq
Catherine Dubos-Arvis
Aldo Renault
Florian Guisier
Luc Odier
Radj Gervais
Christos Chouaïd
Publication date
01-08-2018
Publisher
Springer International Publishing
Published in
Targeted Oncology / Issue 4/2018
Print ISSN: 1776-2596
Electronic ISSN: 1776-260X
DOI
https://doi.org/10.1007/s11523-018-0581-2

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