ecancermedicalscience

Research

Reduced frequency dosing of osimertinib in EGFR-mutant non-small cell lung carcinoma: real world data

28 Jun 2024
Vanita Noronha, Harsh Sahu, Akhil Kapoor, Vijay Patil, Nandini Menon, Minit Shah, Dilan Davis, Rumeli Roy, Srigadha Vivek, Amit Janu, Rajiv Kaushal, Kumar Prabhash

Introduction: Osimertinib is more efficacious and as safe as first-generation epidermal growth factor receptor (EGFR)-directed tyrosine kinase inhibitors. However, osimertinib is not affordable for most patients in developing nations. Moreover, the minimum biologically effective dose of osimertinib may be less than the approved dose.

Materials and methods: This was a retrospective observational multicentric study aimed to describe the efficacy (objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), overall survival (OS)) and toxicity of osimertinib 80 mg orally administered less frequently than daily (ranging from every other day to once-a-week) in patients with EGFR-mutated non-small cell lung cancer.

Results: Between January 2021 and August 2023, we enrolled 22 patients. Six received osimertinib 80 mg once-a-week, nine received 80 mg once-in-3-days and seven received 80 mg on alternate days. Responses included 0 complete responses, 7 (31.8%) partial responses, 9 (40.9%) stable disease and 5 (22.7%) progressive disease. ORR was 31.8%, and DCR was 72.7%. Median PFS was 9.2 months (95% confidence interval (CI) 2.9–15.7), and median OS was 17.8 months (95% CI, 3.2–32.6). In patients who received reduced frequency osimertinib in the second line and beyond, the ORR was 29.4%, DCR was 70.5%, median PFS was 5.9 months (95% CI, 1.1–10.6) and median OS was 17.6 months (95% CI, 2.9–32.2). Grade 3 and higher toxicities were noted in 8 (36.3%) patients.

Conclusion: Less frequent dosing of osimertinib may be a valid treatment option, especially in the second line and beyond setting in patients who cannot afford full dose daily osimertinib. This may provide an additional treatment option with a similar toxicity profile as that of standard dose osimertinib.

Related Articles

Mohammad Saad Salim Naviwala, Mirza Rameez Samar, Daania Shoaib, Fizza Akbar, Romana Idrees, Yasmin Abdul Rashid
Luís Felipe Leite da Silva, Erick Figueiredo Saldanha, Lucas Diniz da Conceição, Wolney de Andrade Martins, Ronaldo Altenburg Gismondi, Erito Marques de Souza Filho, Renata D’Alpino Peixoto
Vanita Noronha, Laboni Sarkar, Vijay Patil, Nandini Menon, Minit Shah, Akash Pawar, Oindrila Roy Chowdhury, Omshree Shetty, Anuradha Chougule, Pratik Chandrani, Rajiv Kaushal, Trupti Pai, Amit Janu, Nivedita Chakrabarty, Kumar Prabhash
Bivas Biswas, Nikhil S Ghadyalpatil, Shekar Patil, Amol Patel, Sandip Ganguly, Anvesh Rathore, Bhupesh Guleria, Cpalli Firdouse Tarannum, Joydeep Ghosh, Mary Sravani Kondapally, Ravi Thippeswamy, Shashidhara Haragadde Poppa Reddy, Somnath Roy
Goutam Santosh Panda, Vanita Noronha, Vijay Patil, Amit Joshi, Nandini Menon, Rajiv Kumar, Trupti Pai, Omshree Shetty, Amit Janu, Nivedita Chakrabarty, Nilendu Purandare, Sayak Dey, Kumar Prabhash