Retrospective study of real-world outcomes with osimertinib for EGFR-mutant NSCLC in elderly patients in Japan

Osimertinib is the primary treatment for patients with EGFR mutation-positive advanced non-small cell lung cancer (aNSCLC). Evidence of real-world outcomes of this treatment in elderly patients (over 75 years of age) is limited. The retrospective OSI-FACT-EP study at Kumamoto University (Japan) included 203 elderly and 335 non-elderly patients receiving first-line osimertinib. Progression-free survival was not significantly different between the groups (median, 16.9 months versus 22.1 months; p=0.093), but median time to treatment failure was 14.0 months versus 21.8 months (p<0.001). Rate of treatment discontinuation because of adverse events was 28.6% versus 14.9% (p<0.001). Among patients who discontinued treatment, the conversion rate to second-line treatment was 39.6% in the elderly and 72.8% in the non-elderly. Median overall survival was 30 months versus not reached (p<0.001). The authors conclude that, in a real-world clinical setting, elderly patients had worse outcomes with first-line osimertinib for EGFR mutation-positive aNSCLC when compared to non-elderly patients.