Retrospective single-center study of real-world outcomes with osimertinib versus afatinib or erlotinib for mNSCLC with atypical EGFR mutations

A real-world retrospective analysis at the University of Pennsylvania (Philadelphia) compared first-line osimertinib versus afatinib or erlotinib for metastatic non-small cell lung cancer (mNSCLC) with atypical mutations in EGFR: G719X, exon20, L861Q, S768I, or C797S. Osimertinib yielded superior median progression-free survival (22 months) versus afatinib (12 months; p=0.005) or erlotinib (9 months; p=0.001) and also superior median overall survival (32 months) versus afatinib (21 months; p=0.032) or erlotinib (17 months; p=0.011). Dose reductions due to adverse events and discontinuations due to adverse events were less frequent with osimertinib than with afatinib or erlotinib. The authors conclude that in a large real-world analysis, first-line osimertinib demonstrated superior progression-free and overall survival and improved tolerability compared to afatinib of erlotinib for atypical EGFR-mutated mNSCLC.