A Real-World Analysis of Immune Checkpoint Inhibitor-Based Therapy After Osimertinib Treatment in Patients With EGFR-Mutant NSCLC

Kenji Morimoto, MD, PhD; Ryo Sawada, MD; Tadaaki Yamada, MD, PhD; Koichi Azuma, MD, PhD; Kentaro Ito, MD; Yasuhiro Goto, MD, PhD; Hideharu Kimura, MD, PhD; Taishi Harada, MD; Shinsuke Shiotsu, MD; Nobuyo Tamiya, MD, PhD; Yusuke Chihara, MD, PhD; Takayuki Takeda, MD, PhD; Osamu Hiranuma, MD; Isao Hasegawa, MD, PhD; Yoshie Morimoto, MD, PhD; Masahiro Iwasaku, MD, PhD; Shinsaku Tokuda, MD, PhD; Koichi Takayama, MD, PhD

JTO Clinical and Research Reports (Sep 2022)

A Real-World Analysis of Immune Checkpoint Inhibitor-Based Therapy After Osimertinib Treatment in Patients With EGFR-Mutant NSCLC

Kenji Morimoto, MD, PhD,
Ryo Sawada, MD,
Tadaaki Yamada, MD, PhD,
Koichi Azuma, MD, PhD,
Kentaro Ito, MD,
Yasuhiro Goto, MD, PhD,
Hideharu Kimura, MD, PhD,
Taishi Harada, MD,
Shinsuke Shiotsu, MD,
Nobuyo Tamiya, MD, PhD,
Yusuke Chihara, MD, PhD,
Takayuki Takeda, MD, PhD,
Osamu Hiranuma, MD,
Isao Hasegawa, MD, PhD,
Yoshie Morimoto, MD, PhD,
Masahiro Iwasaku, MD, PhD,
Shinsaku Tokuda, MD, PhD,
Koichi Takayama, MD, PhD

Affiliations

Kenji Morimoto, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Ryo Sawada, MD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan
Tadaaki Yamada, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Corresponding author. Address for correspondence: Tadaaki Yamada, MD, PhD, Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan.
Koichi Azuma, MD, PhD: Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka City, Japan
Kentaro Ito, MD: Respiratory Center, Matsusaka Municipal Hospital Respiratory Center, Matsusaka, Japan
Yasuhiro Goto, MD, PhD: Department of Respiratory Medicine, Fujita Health University of Medicine, Aichi, Japan
Hideharu Kimura, MD, PhD: Respiratory Medicine, Kanazawa University Hospital, Ishikawa, Japan
Taishi Harada, MD: Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan
Shinsuke Shiotsu, MD: Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
Nobuyo Tamiya, MD, PhD: Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
Yusuke Chihara, MD, PhD: Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
Takayuki Takeda, MD, PhD: Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
Osamu Hiranuma, MD: Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
Isao Hasegawa, MD, PhD: Department of Pulmonary Medicine, Saiseikai Shiga Hospital, Shiga, Japan
Yoshie Morimoto, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Masahiro Iwasaku, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Shinsaku Tokuda, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Koichi Takayama, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

Journal volume & issue: Vol. 3, no. 9
p. 100388

Abstract

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Introduction: The use of immune checkpoint inhibitors (ICIs) with chemotherapy has increased the survival of patients with advanced NSCLC. Nevertheless, the efficacy of ICI treatment for NSCLC with EGFR mutations is limited. Previous studies have not evaluated the efficacy of ICI treatment after osimertinib treatment in real-world settings. Methods: This study performed a retrospective analysis of the association between clinical characteristics and ICI efficacy in patients with EGFR-mutant NSCLC treated with ICIs after osimertinib treatment at 12 institutions in Japan from March 2016 to March 2021. Results: Among 80 patients with EGFR-mutant lung cancer, 42 received ICI monotherapy and 38 received chemoimmunotherapy. In the chemoimmunotherapy group, the progression-free survival (PFS) was significantly longer in the group that exhibited PFS more than 10 months with osimertinib than in the group that exhibited PFS less than or equal to 10 months with osimertinib (8.4 mo versus 3.8 mo, p = 0.026). Nevertheless, there was no significant difference in PFS in the ICI monotherapy group (1.7 mo versus 1.5 mo, p = 0.45). Regardless of the EGFR mutation subtype, PFS of osimertinib treatment was a predictor of the PFS of chemoimmunotherapy (exon 19 deletion mutation: p = 0.03 and exon 21 L858R mutation: p = 0.001). Conclusions: The PFS of osimertinib might be a predictor of PFS of chemoimmunotherapy in patients with EGFR-mutant NSCLC. Further clinical investigations on the predictors of efficacy of administering ICIs after osimertinib treatment are required.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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