Author(s) :

Mircea, Aurelia , Cristina Ligia , Petra, Polixenia , Bogdan .

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Abstract :

Background: To characterize clinical outcomes, treatments and proportion of T790M testing in patients with advanced non-small cell lung cancer (NSCLC) receiving first- or second-generation (1G/2G) tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) in first-line (1L) in the Romanian cohort of an international study. Methods: REFLECT was a retrospective, non-interventional study conducted in 8 countries, with 11 sites from Romania that retrieved data from the medical records of 90 patients. Eligible patients had confirmed EGFR-mutated advanced NSCLC with 1G/2G EGFR TKIs initiated between Jan 2015 and Jun 2018. All analyses are descriptive. Results: In the Romanian cohort, the median age at diagnosis was 67.5 years, with 68% females. Distribution of 1L EGFR TKIs was 50% erlotinib, 31% afatinib, and 19% gefitinib. 1L was discontinued in 76 (84%) patients due to progression (79%), toxicities (3%), patient’s decision (1%) or surgery (1%). Median progression free survival on 1L was 12.0 (95% CI 10.3-15.6) months, and median overall survival from 1L start was 26.4 (95% CI 22.4-34.2) months. T790M testing was performed for 69% patients progressing on 1L, and 57% of patients tested yielded positive results. Second-line (2L) was started in 63% of patients discontinuing 1L. Third-line was started in 50% patients discontinuing 2L. Conclusion: Survival outcomes mirrored the results of randomized trials. Suboptimal T790M testing rate (69%) underlines the importance of reflex testing procedures, while attrition rates on 1L (26%) emphasize the need of upfront selection of most effective treatments. Clinicaltrials.gov registration number: NCT04031898 Date of registration on clinicaltrials.gov: 04-Jul-2019

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