ArticleESMO real world data and digital oncology2024
Real-world outcomes of treatment strategy between first-line osimertinib, first/second-generation EGFR-TKIs followed by osimertinib and without osimertinib in advanced EGFR-mutant NSCLC.
Article in ESMO real world data and digital oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Therapeutic Impact of Third-generation Tyrosine Kinase Inhibitors on Lung Squamous Cell Carcinoma with Epidermal Growth Factor Receptor Mutations: A Case Description and Systematic Literature Review.Internal medicine (Tokyo, Japan) · 2026Pooled it
- Targeting ClassicalCancers · 2026Review
- Real-World Survival Outcomes in EGFR-Mutant Advanced NSCLC Treated With EGFR TKIs: Insights From a Single-Center Clinical Data Warehouse Analysis in South Korea.Asia-Pacific journal of clinical oncology · 2026Article
- Efficacy of EGFR tyrosine kinase inhibitors in patients with non-small cell lung cancer with EGFR exon 19 insertions: clinical-genomic, preclinical analysis through LC-SCRUM-Asia (multi-institutional genomic screening registry).Lung cancer (Amsterdam, Netherlands) · 2025Article
- Solid Predominant Histology and High Podoplanin Expression in Cancer-Associated Fibroblast Predict Primary Resistance to Osimertinib inJTO clinical and research reports · 2025Article
- Reply to the Correspondence regarding "Sequencing the anti-EGFR-TKIs; route to the longest survival" by H.G. Güzel et al.ESMO real world data and digital oncology · 2025Article
- Access to Diagnostics and Treatment for People With Metastatic EGFR-Positive NSCLC: Lessons From Project PRIORITY.JTO clinical and research reports · 2025Article
- EGFR, TP53, and CUL3 Triple Mutation in Non-Small Cell Lung Cancer and its Potentially Poor Prognosis: A Case Report and Database Analysis.Thoracic cancer · 2025Article
- Tyrosine kinase inhibitors in first-line treatment of advanced NSCLC with epidermal growth factor receptor mutations: Real-world data from Vietnam.Oncology research · 2025Article
- Sequencing the anti-EGFR-TKIs; route to the longest survival.ESMO real world data and digital oncology · 2024Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Osimertinib has been the standard of care in epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer (NSCLC). We evaluated outcomes between osimertinib and first/second-generation (1G/2G) EGFR-tyrosine kinase inhibitors (TKIs) as first-line (1L), and investigated how T790M status and sequential osimertinib after 1G/2G EGFR-TKI failure affected overall survival (OS). Materials and methods: We retrospectively evaluated the outcomes of patients with advanced NSCLC harboring exon 19 deletion or L858R mutation who received osimertinib and 1G/2G EGFR-TKIs as 1L treatment from January 2015 to March 2021. In the exploratory analysis, we analyzed the outcomes among three groups: osimertinib as 1L (1L-Osi), 1L 1G/2G EGFR-TKIs followed by osimertinib (2L-Osi), and 1L 1G/2G EGFR-TKIs without osimertinib (No-Osi). Propensity score matching (PSM) and 12-month landmark analysis were used to mitigate selection bias and immortal time bias. Results: Of 485 patients, 213 and 272 received 1L osimertinib and 1L 1G/2G EGFR-TKIs. All 2L-Osi patients had T790M mutations after 1G/2G EGFR-TKI failure. OS did not differ according to 1L EGFR-TKIs [osimertinib versus 1G/2G EGFR-TKIs; 33.7 versus 41.8 months; hazard ratio (HR) 0.92; 95% confidence interval (CI) 0.65-1.29]. In the 12-month landmark analysis, the median OS was 34.4 months [95% CI 21.3 months-not reached (NR)] in 1L-Osi, 63.8 months (95% CI 46.0 months-NR) in 2L-Osi, and 22.5 months (95% CI 19.0-35.3 months) in No-Osi. After PSM, similar results were observed. Conclusions: There was no significant difference in OS between osimertinib and 1G/2G EGFR-TKIs as 1L treatment in patients with EGFR-mutant NSCLC. However, 2L osimertinib following 1L 1G/2G EGFR-TKIs in patients who would acquire T790M mutation has been linked to a better prognosis compared to 1L osimertinib.
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