Real-World Testing Practices, Treatment Patterns and Clinical Outcomes in Patients from Central Eastern Europe with EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Retrospective Chart Review Study (REFLECT)

Urška Janžič; Nina Turnšek; Mircea Dediu; Ivan Shterev Donev; Roxana Lupu; Gabriela Teodorescu; Tudor E Ciuleanu; Adam Pluzanski

doi:10.3390/curroncol29080460

Real-World Testing Practices, Treatment Patterns and Clinical Outcomes in Patients from Central Eastern Europe with EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Retrospective Chart Review Study (REFLECT)

Curr Oncol. 2022 Aug 17;29(8):5833-5845. doi: 10.3390/curroncol29080460.

Authors

Urška Janžič¹, Nina Turnšek², Mircea Dediu³, Ivan Shterev Donev⁴, Roxana Lupu⁵, Gabriela Teodorescu⁵, Tudor E Ciuleanu⁶, Adam Pluzanski⁷

Affiliations

¹ Medical Oncology Department, University Clinic of Respiratory and Allergic Diseases, 4204 Golnik, Slovenia.
² Medical Oncology Department, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
³ Sanador Oncology Center, 010991 Bucharest, Romania.
⁴ Department of Medical Oncology, MHAT Nadezhda, 1330 Sofia, Bulgaria.
⁵ Medical Department, AstraZeneca Romania, 013713 Bucharest, Romania.
⁶ Medical Oncology Department, Oncology Institute Prof. Dr. Ion Chiricuta, 400015 Cluj-Napoca, Romania.
⁷ Lung Cancer and Chest Tumours Department, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.

Abstract

The targeted therapy with tyrosine kinase inhibitors (TKIs) against the epidermal growth factor receptor mutation (EGFRm) in advanced non-small cell lung cancer (NSCLC) changed the treatment paradigm. REFLECT study (NCT04031898) explored EGFR/T790M testing and treatment patterns in EGFRm NSCLC patients receiving first- or second-generation (1G/2G) EGFR TKIs as front-line (1L) in eight countries. Pooled data from Central Eastern Europe (CEE) countries from this study (Bulgaria, Poland, Romania, Slovenia) are presented here. This physician-led chart review study was conducted in patients with confirmed-EGFRm NSCLC initiating 1L 1G/2G EGFR TKIs between 2015-2018. The CEE cohort included 389 patients receiving 1L erlotinib (37%), afatinib (34%), and gefitinib (29%). Overall, 320 (82%) patients discontinued 1L, and 298 (77%) progression events were registered. Median progression free survival on 1L TKIs was 14.0 (95% CI: 12.6-15.6) months. Median overall survival from 1L start was 26.6 (95% CI: 24.1-29.0) months. Attrition rate between 1L and next line was 30%. Among patients with 1L progression, 200 (67%) were tested for T790M and 58% were positive. This first CEE analysis of treatments and outcomes in EGFRm NSCLC patients highlights the importance of using the most efficacious therapies currently available in 1L to reduce attrition and improve patient outcomes.

Keywords: EGFR T790M mutation; advanced non-small cell lung cancer; real-world retrospective study.

Publication types

Clinical Study
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Non-Small-Cell Lung* / drug therapy
Carcinoma, Non-Small-Cell Lung* / genetics
ErbB Receptors / genetics
Humans
Lung Neoplasms* / drug therapy
Lung Neoplasms* / genetics
Mutation
Protein Kinase Inhibitors
Retrospective Studies

Substances

Protein Kinase Inhibitors
EGFR protein, human
ErbB Receptors

Associated data

ClinicalTrials.gov/NCT04031898

Grants and funding

The study NCT04031898 was funded by AstraZeneca. AstraZeneca played a role in the design and conduct of the study; data collection, and analysis, and interpretation of data; and review and approval of the manuscript.