RT Journal Article
T1 Comparative Clinical Outcomes Between EGFR Ex20ins and Wildtype NSCLC Treated with Immune Checkpoint Inhibitors.
A1 Girard, Nicolas
A1 Minchom, Anna
A1 Ou, Sai-Hong Ignatius
A1 Gadgeel, Shirish M
A1 Trigo, Jose
A1 Viteri, Santiago
A1 Bauml, Joshua M
A1 Londhe, Anil
A1 Mahadevia, Parthiv
A1 Bazhenova, Lyudmila
K1 Immunotherapy
K1 Mutation
K1 Real-world data
K1 Real-world overall survival
K1 Time to next treatment
AB The activity of immune checkpoint inhibitors (ICIs) in NSCLC harboring EGFR exon 20 insertion mutations (ex20ins) has not been closely examined due to the frequent exclusion of patients with EGFR mutations from large immunotherapy-based NSCLC trials. A real-world, retrospective study was conducted to compare outcomes of ICI-treated patients with EGFR ex20ins and wildtype NSCLC (wt-NSCLC; defined as EGFR and ALK test negative). Patients with advanced NSCLC from the Flatiron Health database (2015-2020) were included in the analysis. Real-world time to next therapy (rwTTNT) and overall survival (rwOS), stratified by ICI initiation line of therapy, were the prespecified primary and secondary endpoints, respectively. Among 59 patients with EGFR ex20ins NSCLC and 5365 with wt-NSCLC, ICI treatment was received as first-line therapy in 25% and 39%, respectively. Patients with EGFR ex20ins had a 58% increased risk of shorter time to next-line therapy compared with wt-NSCLC (adjusted hazard ratio of 1.58 [95% confidence interval [CI], 1.2-2.1]; P = .0012). The median rwTTNT for first ICI line was 3.7 months (95% CI, 3.0-4.9) for EGFR ex20ins NSCLC compared with 5.8 months (95% CI, 5.6-6.0) for wt-NSCLC. No meaningful difference in rwOS between the groups was observed. ICI therapy may be less effective for patients with EGFR ex20ins compared with wt-NSCLC. Consistent with prior data on exon 19 deletion and L858R substitution, tumors harboring ex20ins appear to be less responsive to immune checkpoint inhibition than wt-NSCLC.
PB Elsevier
YR 2022
FD 2022-07-21
LK http://hdl.handle.net/10668/22105
UL http://hdl.handle.net/10668/22105
LA en
NO Girard N, Minchom A, Ou SI, Gadgeel SM, Trigo J, Viteri S, et al. Comparative Clinical Outcomes Between EGFR Ex20ins and Wildtype NSCLC Treated with Immune Checkpoint Inhibitors. Clin Lung Cancer. 2022 Nov;23(7):571-577
DS RISalud
RD Apr 19, 2025