PMID- 38090527
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231213
IS  - 2218-6751 (Print)
IS  - 2226-4477 (Electronic)
IS  - 2218-6751 (Linking)
VI  - 12
IP  - 11
DP  - 2023 Nov 30
TI  - Osimertinib versus comparator first-generation epidermal growth factor receptor 
      tyrosine kinase inhibitors as first-line treatment in patients with advanced 
      EGFR-mutated non-small cell lung cancer: a Chinese, multicenter, real-world 
      cohort study.
PG  - 2229-2244
LID - 10.21037/tlcr-23-577 [doi]
AB  - BACKGROUND: In the phase 3 FLAURA trial, osimertinib was compared with 
      first-generation epidermal growth factor receptor tyrosine kinase inhibitors 
      (EGFR-TKIs) as a first-line treatment for EGFR-mutant non-small cell lung cancer 
      (NSCLC). Osimertinib showed longer progression-free survival (PFS), overall 
      survival (OS), and a similar safety profile. However, more studies demonstrating 
      the effectiveness and safety of osimertinib as a first-line strategy are needed 
      in real-world populations. METHODS: We enrolled 1,556 patients with EGFR-mutated 
      stage IIIc-IV NSCLC from the CAPTRA-Lung database. All patients received either 
      osimertinib (n=202) or a first-generation EGFR-TKI (n=1,354) as their initial 
      treatment. To adjust for differences in baseline characteristics between two 
      groups, 1:2 propensity score matching (PSM) was performed. Propensity scores 
      included gender, age, Eastern Cooperative Oncology Group performance status 
      score, smoking history, family history of tumor, pathology, EGFR mutations, and 
      central nervous system (CNS) metastases. The standardized mean differences (SMD) 
      before and after PSM were calculated to examine the balance of covariate 
      distributions between two groups. RESULTS: After PSM, 202 patients receiving 
      osimertinib and 404 patients receiving first-generation EGFR-TKIs were finally 
      identified. SMD of each matched variable is less than 0.10. The median PFS was 
      19.4 months [95% confidence interval (CI): 14.3-24.4] in the osimertinib arm and 
      10.9 months (95% CI: 9.3-12.5) in the comparator arm [hazard ratio (HR) for 
      progression, 0.47; 95% CI: 0.38-0.59; P<0.001). The median OS was 40.5 months 
      (95% CI: 27.1-54.0) vs. 34.3 months (95% CI: 30.6-38.0) in two groups, 
      respectively (HR for death, 0.76; 95% CI: 0.58-1.00; P=0.045). The incidence of 
      grade 3 adverse events (AEs) between the two groups was 1% and 4.2%, 
      respectively. No grade 4 AEs and treatment-related deaths were reported in both 
      groups. CONCLUSIONS: In real-world settings, osimertinib demonstrates longer PFS 
      and OS, with a similar safety profile to that of comparator EGFR-TKIs when used 
      as a first-line strategy in NSCLC patients.
CI  - 2023 Translational Lung Cancer Research. All rights reserved.
FAU - Zhang, Dongming
AU  - Zhang D
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Liu, Xiaoyan
AU  - Liu X
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Shen, Fangfang
AU  - Shen F
AD  - Department of Respiratory Medicine, Shanxi Province Cancer Hospital, Cancer 
      Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
FAU - Zhao, Dahai
AU  - Zhao D
AD  - Department of Respiratory and Critical Care Medicine, The Second Affiliated 
      Hospital, Anhui Medical University, Hefei, China.
FAU - Shi, Yuequan
AU  - Shi Y
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Zhang, Haoran
AU  - Zhang H
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Liu, Jia
AU  - Liu J
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Gao, Xiaoxing
AU  - Gao X
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Chen, Minjiang
AU  - Chen M
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Zhao, Jing
AU  - Zhao J
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Zhong, Wei
AU  - Zhong W
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Gao, Junzhen
AU  - Gao J
AD  - Department of Respiratory and Critical Care Medicine, The Affiliated hospital of 
      Inner Mongolia Medical University, Inner Mongolia, China.
FAU - He, Min
AU  - He M
AD  - Department of Oncology, Inner Mongolia Autonomous Region People's Hospital, Inner 
      Mongolia, China.
FAU - Liu, Yonggang
AU  - Liu Y
AD  - Department of Thoracic Oncology, Baotou Cancer Hospital, Inner Mongolia, China.
FAU - Yang, Xiaoling
AU  - Yang X
AD  - Department of Thoracic Oncology, Shanxi Bethune Hospital, Third Hospital of 
      Shanxi Medical University, Taiyuan, China.
FAU - Qin, Jianwen
AU  - Qin J
AD  - Department of Respiratory and Critical Medicine, Tianjin Chest Hospital, Tianjin, 
      China.
FAU - Tang, Yuling
AU  - Tang Y
AD  - Respiratory Medical Center, First Hospital of Changsha, Changsha, China.
FAU - Mu, Xinlin
AU  - Mu X
AD  - Department of Respiratory and Critical Care Medicine, Peking University People's 
      Hospital, Beijing, China.
FAU - Gu, Yangchun
AU  - Gu Y
AD  - Department of Medical Oncology and Radiation Sickness, Peking University Third 
      Hospital, Beijing, China.
FAU - Zhang, Shucai
AU  - Zhang S
AD  - Department of Oncology, Beijing Chest Hospital, Capital Medical University, 
      Beijing, China.
FAU - Chen, Xueqin
AU  - Chen X
AD  - Department of Thoracic Oncology, Hangzhou Cancer Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Pang, Li
AU  - Pang L
AD  - Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital 
      Medical University, Beijing, China.
FAU - Meng, Qingwei
AU  - Meng Q
AD  - Department of Medical Oncology, Harbin Medical University Cancer Hospital, 
      Harbin, China.
FAU - Guo, Ye
AU  - Guo Y
AD  - Cancer Center, The First Hospital of Jilin University, Changchun, China.
FAU - Zhang, Yuhui
AU  - Zhang Y
AD  - Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, 
      Capital Medical University, Beijing, China.
FAU - Li, Wei
AU  - Li W
AD  - Department of Respiratory and Critical Care Medicine, The First Affiliated 
      Hospital of Bengbu Medical College, Bengbu, China.
FAU - Xing, Puyuan
AU  - Xing P
AD  - Department of Medical Oncology, National Cancer Center, National Clinical 
      Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Beijing, China.
FAU - Cheng, Yuan
AU  - Cheng Y
AD  - Department of Respiratory and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Xin, Tao
AU  - Xin T
AD  - Department of Oncology, The Second Affiliated Hospital of Harbin Medical 
      University, Harbin, China.
FAU - Li, Qingxia
AU  - Li Q
AD  - Department of Oncology, Hebei General Hospital, Shijiazhuang, China.
FAU - Li, Yu
AU  - Li Y
AD  - Department of Respiratory Medicine, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Chen, Jun
AU  - Chen J
AD  - Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical 
      University General Hospital, Tianjin, China.
FAU - Gao, Feng
AU  - Gao F
AD  - Department of Oncology, Beidahuang Industry Group General Hospital, Harbin, 
      China.
FAU - Jin, Bo
AU  - Jin B
AD  - Department of Medical Oncology, The First Hospital of China Medical University, 
      Shenyang, China.
FAU - Rossi, Antonio
AU  - Rossi A
AD  - Oncology Center of Excellence, Therapeutic Science & Strategy Unit, IQVIA, Milan, 
      Italy.
FAU - Adachi, Hiroyuki
AU  - Adachi H
AD  - Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
FAU - Guerrera, Francesco
AU  - Guerrera F
AD  - Department of Surgical Science, University of Torino, Torino, Italy.
AD  - Department of Thoracic Surgery, Azienda Ospedaliera Universitaria Citta della 
      Salute e della Scienza di Torino, Torino, Italy.
FAU - Husain, Hatim
AU  - Husain H
AD  - Department of Medicine, University of California San Diego, La Jolla, CA, USA.
FAU - Xu, Yan
AU  - Xu Y
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
FAU - Wang, Mengzhao
AU  - Wang M
AD  - Department of Respiratory and Critical Care Medicine, Peking Union Medical 
      College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical 
      College, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20231026
PL  - China
TA  - Transl Lung Cancer Res
JT  - Translational lung cancer research
JID - 101646875
PMC - PMC10713260
OTO - NOTNLM
OT  - Osimertinib
OT  - comparator epidermal growth factor receptor tyrosine kinase inhibitor (comparator 
      EGFR-TKI)
OT  - propensity score matching (PSM)
OT  - real-world study
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-577/coif). A.R. received 
      stock options by IQVIA Holdings Inc. H.H. has received consulting fees from 
      Janssen and Astrazeneca and honoraria from Janssen, Astrazeneca, Neogenomics, and 
      Foundation Medicine. The other authors have no conflicts of interest to declare.
EDAT- 2023/12/13 18:42
MHDA- 2023/12/13 18:43
PMCR- 2023/11/30
CRDT- 2023/12/13 13:10
PHST- 2023/09/06 00:00 [received]
PHST- 2023/10/20 00:00 [accepted]
PHST- 2023/12/13 18:43 [medline]
PHST- 2023/12/13 18:42 [pubmed]
PHST- 2023/12/13 13:10 [entrez]
PHST- 2023/11/30 00:00 [pmc-release]
AID - tlcr-12-11-2229 [pii]
AID - 10.21037/tlcr-23-577 [doi]
PST - ppublish
SO  - Transl Lung Cancer Res. 2023 Nov 30;12(11):2229-2244. doi: 10.21037/tlcr-23-577. 
      Epub 2023 Oct 26.