Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment
Abstract Background Osimertinib yields significant tumor responses and durations of progression‐free survival (PFS) in patients with acquired T790M mutations. However, the evidence supporting liquid biopsy‐guided treatment is still limited. This study examined the real‐world benefits of osimertinib...
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doaj-fb79b51197984d75892ed6f10ff260d52020-11-25T02:32:57ZengWileyCancer Medicine2045-76342019-10-018135939594710.1002/cam4.2485Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatmentPo‐Lan Su0Szu‐Chun Yang1Yi‐Lin Chen2Yi‐Lin Wu3Chia‐Ying Lin4Wei‐Yuan Chang5Yau‐Lin Tseng6Wu‐Wei Lai7Chung‐Liang Ho8Chien‐Chung Lin9Wu‐Chou Su10Department of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Pathology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Nursing National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Diagnostic Radiology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Surgery National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Surgery National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Pathology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanDepartment of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan TaiwanAbstract Background Osimertinib yields significant tumor responses and durations of progression‐free survival (PFS) in patients with acquired T790M mutations. However, the evidence supporting liquid biopsy‐guided treatment is still limited. This study examined the real‐world benefits of osimertinib in patients with tissue or plasma T790M mutations. Methods From January 2016 to June 2018, a total of 183 non‐small‐cell lung cancer patients were enrolled. The presence of the T790M mutation was assessed by either tissue or plasma. The PFS, overall survival, and tumor response rates of the patients were calculated and compared with those of previous clinical trials. Results T790M mutations were detected in 51.5% of the patients, including 64 of 140 (45.7%) who underwent liquid biopsies and 23 of 29 (79.3%) who underwent tumor biopsies. After excluding those in clinical trials, 46 patients received osimertinib, including 33 with positive plasma and 13 with positive tissue results for T790M mutations. The median PFS was 11.3 months (interquartile range: 5.2‐NR) in all the T790M‐positive patients and 10.1 months (interquartile range: 5.9‐NR) in the plasma T790M‐positive patients. The overall survival, meanwhile, was not reached, whereas the one‐year survival rate was 66.1% in all the patients and 61.4% in those who were plasma T790M‐positive. The objective response rate and disease control rate were 37.8% and 91.9% in all the patients and 34.6% and 92.3% in the plasma T790M‐positive group, respectively. Using a Cox proportional hazards regression, we determined that male gender was a poor prognostic factor for PFS. Conclusions In this retrospective real‐world analysis, it was determined that both tissue and plasma T790M mutations can be used to guide treatment with osimertinib. Similar disease control rates and survival durations were observed in comparison to those of phase 3 clinical trials.https://doi.org/10.1002/cam4.2485circulating tumor DNANSCLCosimertinibprogression‐free survivalT790M mutation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Po‐Lan Su Szu‐Chun Yang Yi‐Lin Chen Yi‐Lin Wu Chia‐Ying Lin Wei‐Yuan Chang Yau‐Lin Tseng Wu‐Wei Lai Chung‐Liang Ho Chien‐Chung Lin Wu‐Chou Su |
spellingShingle |
Po‐Lan Su Szu‐Chun Yang Yi‐Lin Chen Yi‐Lin Wu Chia‐Ying Lin Wei‐Yuan Chang Yau‐Lin Tseng Wu‐Wei Lai Chung‐Liang Ho Chien‐Chung Lin Wu‐Chou Su Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment Cancer Medicine circulating tumor DNA NSCLC osimertinib progression‐free survival T790M mutation |
author_facet |
Po‐Lan Su Szu‐Chun Yang Yi‐Lin Chen Yi‐Lin Wu Chia‐Ying Lin Wei‐Yuan Chang Yau‐Lin Tseng Wu‐Wei Lai Chung‐Liang Ho Chien‐Chung Lin Wu‐Chou Su |
author_sort |
Po‐Lan Su |
title |
Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment |
title_short |
Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment |
title_full |
Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment |
title_fullStr |
Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment |
title_full_unstemmed |
Real‐world outcomes of NSCLC patients receiving tissue or circulating tumor DNA‐guided osimertinib treatment |
title_sort |
real‐world outcomes of nsclc patients receiving tissue or circulating tumor dna‐guided osimertinib treatment |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2019-10-01 |
description |
Abstract Background Osimertinib yields significant tumor responses and durations of progression‐free survival (PFS) in patients with acquired T790M mutations. However, the evidence supporting liquid biopsy‐guided treatment is still limited. This study examined the real‐world benefits of osimertinib in patients with tissue or plasma T790M mutations. Methods From January 2016 to June 2018, a total of 183 non‐small‐cell lung cancer patients were enrolled. The presence of the T790M mutation was assessed by either tissue or plasma. The PFS, overall survival, and tumor response rates of the patients were calculated and compared with those of previous clinical trials. Results T790M mutations were detected in 51.5% of the patients, including 64 of 140 (45.7%) who underwent liquid biopsies and 23 of 29 (79.3%) who underwent tumor biopsies. After excluding those in clinical trials, 46 patients received osimertinib, including 33 with positive plasma and 13 with positive tissue results for T790M mutations. The median PFS was 11.3 months (interquartile range: 5.2‐NR) in all the T790M‐positive patients and 10.1 months (interquartile range: 5.9‐NR) in the plasma T790M‐positive patients. The overall survival, meanwhile, was not reached, whereas the one‐year survival rate was 66.1% in all the patients and 61.4% in those who were plasma T790M‐positive. The objective response rate and disease control rate were 37.8% and 91.9% in all the patients and 34.6% and 92.3% in the plasma T790M‐positive group, respectively. Using a Cox proportional hazards regression, we determined that male gender was a poor prognostic factor for PFS. Conclusions In this retrospective real‐world analysis, it was determined that both tissue and plasma T790M mutations can be used to guide treatment with osimertinib. Similar disease control rates and survival durations were observed in comparison to those of phase 3 clinical trials. |
topic |
circulating tumor DNA NSCLC osimertinib progression‐free survival T790M mutation |
url |
https://doi.org/10.1002/cam4.2485 |
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