Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression

Background: Patients with non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations who experience disease progression after treatment with an EGFR-tyrosine kinase inhibitor (EGFR-TKI) often receive subsequent treatment with either platinum-based chemotherapy (Ch...

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Main Authors: K. Morimoto, T. Yamada, N. Furuya, H. Tanaka, A. Yoshimura, T. Oba, M. Hibino, T. Fukuda, Y. Goto, A. Nakao, S. Ogusu, Y. Okazaki, T. Harada, T. Ota, K. Masubuchi, K. Mikami, T. Hata, S. Matsumoto, R. Honda, K. Date, Y. Chihara, K. Takayama
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:ESMO Real World Data and Digital Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949820125000414
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author K. Morimoto
T. Yamada
N. Furuya
H. Tanaka
A. Yoshimura
T. Oba
M. Hibino
T. Fukuda
Y. Goto
A. Nakao
S. Ogusu
Y. Okazaki
T. Harada
T. Ota
K. Masubuchi
K. Mikami
T. Hata
S. Matsumoto
R. Honda
K. Date
Y. Chihara
K. Takayama
author_facet K. Morimoto
T. Yamada
N. Furuya
H. Tanaka
A. Yoshimura
T. Oba
M. Hibino
T. Fukuda
Y. Goto
A. Nakao
S. Ogusu
Y. Okazaki
T. Harada
T. Ota
K. Masubuchi
K. Mikami
T. Hata
S. Matsumoto
R. Honda
K. Date
Y. Chihara
K. Takayama
author_sort K. Morimoto
collection DOAJ
description Background: Patients with non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations who experience disease progression after treatment with an EGFR-tyrosine kinase inhibitor (EGFR-TKI) often receive subsequent treatment with either platinum-based chemotherapy (Chemo) or a combination regimen of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP). However, whether the efficacy of prior EGFR-TKI treatment influences the outcomes of Chemo or ABCP remains unclear. Materials and methods: Between January 2017 and July 2022, we retrospectively assessed patients with EGFR-mutant NSCLC who received Chemo or ABCP after EGFR-TKIs across 20 institutions. Results: Overall, data of 350 patients with advanced or recurrent EGFR-mutant NSCLC were analyzed. Of these, 262 patients (74.9%) received Chemo, and 88 (25.1%) received ABCP. No significant difference was noted in progression-free survival (PFS) after Chemo between patients who responded to prior EGFR-TKIs for ≥10 months and those who had responded for <10 months (6.1 versus 5.1 months; log-rank test, P = 0.12). In contrast, patients who responded to prior EGFR-TKIs for ≥10 months exhibited a significantly longer PFS to ABCP (8.7 versus 6.7 months; log-rank test, P = 0.002). After propensity score matching, among patients who responded to prior EGFR-TKIs for ≥10 months, the ABCP group had a significantly longer PFS than the Chemo group (8.6 versus 5.3 months; log-rank test, P = 0.008). Conclusion: The efficacy of prior EGFR-TKI treatment in patients with EGFR-mutant NSCLC who experience disease progression could be a predictive marker for ABCP rather than Chemo efficacy.
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spelling doaj-art-e8aede3b72624444862ab94dce67c1c32025-08-20T03:13:04ZengElsevierESMO Real World Data and Digital Oncology2949-82012025-06-01810015210.1016/j.esmorw.2025.100152Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progressionK. Morimoto0T. Yamada1N. Furuya2H. Tanaka3A. Yoshimura4T. Oba5M. Hibino6T. Fukuda7Y. Goto8A. Nakao9S. Ogusu10Y. Okazaki11T. Harada12T. Ota13K. Masubuchi14K. Mikami15T. Hata16S. Matsumoto17R. Honda18K. Date19Y. Chihara20K. Takayama21Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Correspondence to: Dr Tadaaki Yamada, Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan. Tel: +81-75-251-5513Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, JapanDepartment of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, JapanDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, JapanDepartment of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, JapanDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, JapanDepartment of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, JapanDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, JapanDepartment of Thoracic Oncology, Kansai Medical University, Osaka, JapanDepartment of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama, JapanDepartment of Breast Medical Oncology, Izumi City General Hospital, Izumi, JapanDivision of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, JapanDepartment of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, Nishinomiya, JapanDepartment of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, JapanDepartment of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, JapanDepartment of Respiratory Medicine, Kokuho Asahi Chuo Hospital, Asahi, JapanDepartment of Pulmonary Medicine, Kyoto Chubu Medical Center, Nantan, JapanDepartment of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji, JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanBackground: Patients with non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations who experience disease progression after treatment with an EGFR-tyrosine kinase inhibitor (EGFR-TKI) often receive subsequent treatment with either platinum-based chemotherapy (Chemo) or a combination regimen of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP). However, whether the efficacy of prior EGFR-TKI treatment influences the outcomes of Chemo or ABCP remains unclear. Materials and methods: Between January 2017 and July 2022, we retrospectively assessed patients with EGFR-mutant NSCLC who received Chemo or ABCP after EGFR-TKIs across 20 institutions. Results: Overall, data of 350 patients with advanced or recurrent EGFR-mutant NSCLC were analyzed. Of these, 262 patients (74.9%) received Chemo, and 88 (25.1%) received ABCP. No significant difference was noted in progression-free survival (PFS) after Chemo between patients who responded to prior EGFR-TKIs for ≥10 months and those who had responded for <10 months (6.1 versus 5.1 months; log-rank test, P = 0.12). In contrast, patients who responded to prior EGFR-TKIs for ≥10 months exhibited a significantly longer PFS to ABCP (8.7 versus 6.7 months; log-rank test, P = 0.002). After propensity score matching, among patients who responded to prior EGFR-TKIs for ≥10 months, the ABCP group had a significantly longer PFS than the Chemo group (8.6 versus 5.3 months; log-rank test, P = 0.008). Conclusion: The efficacy of prior EGFR-TKI treatment in patients with EGFR-mutant NSCLC who experience disease progression could be a predictive marker for ABCP rather than Chemo efficacy.http://www.sciencedirect.com/science/article/pii/S2949820125000414non-small-cell lung cancerEGFR mutationimmune checkpoint inhibitoratezolizumab
spellingShingle K. Morimoto
T. Yamada
N. Furuya
H. Tanaka
A. Yoshimura
T. Oba
M. Hibino
T. Fukuda
Y. Goto
A. Nakao
S. Ogusu
Y. Okazaki
T. Harada
T. Ota
K. Masubuchi
K. Mikami
T. Hata
S. Matsumoto
R. Honda
K. Date
Y. Chihara
K. Takayama
Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
ESMO Real World Data and Digital Oncology
non-small-cell lung cancer
EGFR mutation
immune checkpoint inhibitor
atezolizumab
title Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
title_full Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
title_fullStr Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
title_full_unstemmed Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
title_short Prolonged progression-free survival on epidermal growth factor receptor-tyrosine kinase inhibitors predicts superior response to atezolizumab-based therapy over chemotherapy in epidermal growth factor receptor-mutated non-small-cell lung cancer following progression
title_sort prolonged progression free survival on epidermal growth factor receptor tyrosine kinase inhibitors predicts superior response to atezolizumab based therapy over chemotherapy in epidermal growth factor receptor mutated non small cell lung cancer following progression
topic non-small-cell lung cancer
EGFR mutation
immune checkpoint inhibitor
atezolizumab
url http://www.sciencedirect.com/science/article/pii/S2949820125000414
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