ArticleCureus2025
Real-World Treatment Patterns of Metastatic Epidermal Growth Factor Receptor (EGFR)-Mutated Non-small Cell Lung Cancer Patients From the Integra Connect Database.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction Targeted therapies have transformed the treatment landscape of metastatic non-small cell lung cancer (mNSCLC) and are the preferred first-line (1L) treatment option for patients with mNSCLC harboring epidermal growth factor receptor (EGFR) exon 19 deletion (Ex19del) and exon 21 L858R substitution (L858R). However, recent real-world data on patient characteristics and treatment patterns in this population remain limited. This study aimed to describe treatment patterns, including immunotherapy use, in patients with EGFR-mutated (Ex19del/L858R) mNSCLC. Methods This retrospective study descriptively analyzed deidentified Integra Connect data for patients with documented EGFR-mutated (Ex19del/L858R) mNSCLC before initiating 1L treatment on or after January 1, 2018, with 1L initiation as the index date. Results Among 561 patients, the median age was 71 years; 369 (66.1% of 558 patients with known gender information) were female, 375 (66.8%) were White, and 290 (51.9% of 559 patients with known smoking status) never smoked. Ex19del was reported in 286 patients (51.0%) and L858R in 276 (49.2%). Most patients (n = 408, 72.7%) had documented next-generation sequencing testing. The mean (median) time from first recorded metastasis date to 1L initiation was 3.5 (1.1) months. The mean (median) time from first recorded EGFR-positive (Ex19del/L858R) test or test result and 1L initiation was 2.7 (0.5) months. The most common 1L treatments included osimertinib monotherapy (n = 419, 74.7%) and osimertinib combination therapies (n = 61, 10.9%). By data cutoff (June 30, 2024), 245 patients (43.7%) had received a second-line (2L) therapy. Common 2L treatments included chemotherapy-immunotherapy combinations (n = 48, 19.6%), osimertinib monotherapy (n = 42, 17.1%), and immunotherapy monotherapy (n = 25, 10.2%). Overall, 53 patients (9.4%) received immunotherapy as 1L treatment, while nearly one-third (n = 77, 31.4%) of those initiating 2L therapy received immunotherapy. Conclusions Despite guidelines recommending targeted therapy over immunotherapy in patients with EGFR-mutated (Ex19del/L858R) mNSCLC, immunotherapy use in 1L and 2L continues to be observed in the real world, highlighting substantial unmet needs and the need for more effective targeted treatments for these patients.
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