Real-world outcomes with first-line osimertinib versus afatinib for metastatic non-small cell lung cancer with uncommon EGFR-mutations

A retrospective study at 12 US centers evaluated real-world outcomes with first-line osimertinib versus afatinib for mNSCLC patients with uncommon EGFR mutations (other than L858R and exon19del). Among patients with G719X mutations, first-line afatinib was associated with longer time to discontinuation (p=0.047) and longer overall survival (p=0.043) than first-line osimertinib. Among patients with L861Q, first-line osimertinib was associated with longer time to TTD (p=0.004) than first-line afatinib, with no statistical difference in OS (p=0.215). The authors conclude that uncommon EGFR mutations may warrant distinct treatment recommendation based on the specific mutation(s) identified.