Carcinoma, Non-Small-Cell Lung
Conditions
Brief summary
This is a non-interventional, multi-country, multi-centre cohort study based on existing data from medical records of patients with EGFR mutation-positive advanced NSCLC treated with afatinib (Gi(l)otrif®) as the first-line treatment followed by osimertinib in case the T790M resistance mutation was developed.
Interventions
GILOTRIF, GIOTRIF, XOVOLTIB
on T790M resistance mutation was developed
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients with EGFR mutation-positive advanced non-small cell lung cancer (NSCLC) * The tumour harbours common EGFR mutations (Del19, L858R) at start of first-line treatment * Patients who initiated second-line osimertinib treatment for acquired T790M mutation at least 10 months prior to data entry, AND who were treated with afatinib (Gi(l)otrif®) in the first-line * Patients treated with osimertinib within an EAP/CUP or regular clinical practice * Age ≥ 18 years * Signed and dated written informed consent per regulations (Exemption of a written informed consent for NIS based on existing data in countries per local regulations and legal requirements)
Exclusion criteria
* Patients who received drug(s) other than osimertinib as the second-line treatment and/or patients who received drug(s) other than afatinib (Gi(l)otrif®) as the first-line treatment * Patients with active brain metastases at start of treatment (either afatinib/Gi(l)otrif® or osimertinib)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time on Treatment With Afatinib (Gi(l)Otrif®) Followed by Osimertinib | Data collected from start of treatment until data entry completion, up to 96.8 months for first analysis and up to 114.1 months for the extension analysis. | Time on treatment, which was defined as time in months from the start date of Afatinib (Gi\[l\]otrif®) treatment ('start date of initial dose' for First-Line Treatment) to the end date of Osimertinib treatment (maximum between 'end date of initial dose' and the last 'end date of dose modification' for Second-Line Treatment) or death date due to any cause ('date of death'). Time on treatment (months) = Time on treatment (days)/30.4375. 'Time on treatment was analysed using Kaplan-Meier method, and the median along with two-sided 90% confidence interval was displayed using the Greenwood's formula for estimation of standard errors. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Percentage of Participants With Different Types of Mutations After Categorisation | Data collected from start of treatment until data entry completion; up to 96.8 months. | Different types of resistance mutations identified at the time of discontinuation of osimertinib treatment were systematically reviewed and categorised. |
Countries
Austria
Participant flow
Recruitment details
Non-interventional, multi-centre cohort study based on existing data from medical records of patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer (NSCLC) treated with afatinib (Gi\[l\]otrif®) as first-line treatment followed by osimertinib in case the T790M resistance mutation was developed. The study included an extension analysis using additional collected data of the enrolled patients.
Pre-assignment details
All patients were screened for eligibility to participate in the trial. Only patients that met all the inclusion and none of the exclusion criteria were included in the trial.
Participants by arm
| Arm | Count |
|---|---|
| Patients With EGFR Mutation-positive NSCLC Patients with EGFR mutation-positive NSCLC with acquired T790M mutation at least 10 months prior to data entry, and who were treated with afatinib (Gi\[l\]otrif®) (50mg or 40mg or 30mg or 20mg tablet once daily as indicated in the approved labels of afatinib (Gi\[l\]otrif®)) in the first-line line treatment followed by second-line osimertinib treatment (80 milligram (mg) or 40 mg tablets once daily as indicated in the approved labels of osimertinib). | 204 |
| Total | 204 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 2 |
| Overall Study | Death | 5 |
| Overall Study | Patient was followed in another hospital center | 1 |
| Overall Study | Progressive Disease | 98 |
Baseline characteristics
| Characteristic | Patients With EGFR Mutation-positive NSCLC |
|---|---|
| Age, Continuous | 60.1 Years STANDARD_DEVIATION 10.48 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 19 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 181 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 4 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants |
| Race (NIH/OMB) Asian | 50 Participants |
| Race (NIH/OMB) Black or African American | 18 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 13 Participants |
| Race (NIH/OMB) White | 120 Participants |
| Sex: Female, Male Female | 110 Participants |
| Sex: Female, Male Male | 94 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 31 / 203 |
| other Total, other adverse events | 62 / 203 |
| serious Total, serious adverse events | 32 / 203 |
Outcome results
Time on Treatment With Afatinib (Gi(l)Otrif®) Followed by Osimertinib
Time on treatment, which was defined as time in months from the start date of Afatinib (Gi\[l\]otrif®) treatment ('start date of initial dose' for First-Line Treatment) to the end date of Osimertinib treatment (maximum between 'end date of initial dose' and the last 'end date of dose modification' for Second-Line Treatment) or death date due to any cause ('date of death'). Time on treatment (months) = Time on treatment (days)/30.4375. 'Time on treatment was analysed using Kaplan-Meier method, and the median along with two-sided 90% confidence interval was displayed using the Greenwood's formula for estimation of standard errors.
Time frame: Data collected from start of treatment until data entry completion, up to 96.8 months for first analysis and up to 114.1 months for the extension analysis.
Population: Full Analysis Set (FAS): All patients who were enrolled into the study, met all inclusion criteria and did not meet any exclusion criteria and provided a written and signed informed consent. 1 Patient was excluded from extension analysis due to conflicting data on the discontinuation date of osimertinib treatment.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Patients With EGFR Mutation-positive NSCLC | Time on Treatment With Afatinib (Gi(l)Otrif®) Followed by Osimertinib | First analysis | 27.6 Months |
| Patients With EGFR Mutation-positive NSCLC | Time on Treatment With Afatinib (Gi(l)Otrif®) Followed by Osimertinib | Extension analysis | 27.7 Months |
The Percentage of Participants With Different Types of Mutations After Categorisation
Different types of resistance mutations identified at the time of discontinuation of osimertinib treatment were systematically reviewed and categorised.
Time frame: Data collected from start of treatment until data entry completion; up to 96.8 months.
Population: Patients in the Full Analysis Set (FAS), who discontinued treatment and with positive test results (either EGFR sensitizing Mutation and/or T790M) available.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Patients With EGFR Mutation-positive NSCLC | The Percentage of Participants With Different Types of Mutations After Categorisation | Loss of T790M | 20.5 Percentage of participants (%) |
| Patients With EGFR Mutation-positive NSCLC | The Percentage of Participants With Different Types of Mutations After Categorisation | T790M positive, loss of sensitizing mutation | 10.3 Percentage of participants (%) |
| Patients With EGFR Mutation-positive NSCLC | The Percentage of Participants With Different Types of Mutations After Categorisation | T790M positive | 69.2 Percentage of participants (%) |