Octogenarians with EGFR-mutated non-small cell lung cancer treated by tyrosine-kinase inhibitor a multicentric real-world study assessing tolerance and efficacy (OCTOMUT study)

Romain Corre , Radj Gervais (1) , Florian Guisier (2, 3) , Louis Tassy (4) , Florent Vinas , Régine Lamy (5) , Gislaine Fraboulet , Laurent Greillier (6) , Helene Doubre , Renaud Descourt (7) , Christos Chouaid (8) , Jean-Bernard Auliac

1 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
2 Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen]
3 QuantIF-LITIS - Equipe Quantification en Imagerie Fonctionnelle
4 Centre Léon Bérard [Lyon]
5 CH Bretagne Sud
6 Service d'oncologie multidisciplinaire innovations thérapeutiques [Hôpital Nord - APHM]
7 BREST - ICH - Service d'Oncologie Thoracique
8 BCR - Biomécanique cellulaire et respiratoire

Objective. To assess efficacy and tolerance of EGFR tyrosine-kinase inhibitors (TKIs) for advanced EGFR-mutated non-small cell lung cancer (NSCLC) in octogenarians.Patients and methods. Patients aged 80 years or older with EGFR-mutated NSCLC treated by EGFR TKI between January 2011 and March 2015 whatever the line of treatment were retrospectively selected.Results. 20 centers retrospectively included 114 patients (women, 77.2%; Caucasians, 98.3%; mean age, 83.9 years). A performance status of 0–1 or 2–3 at diagnosis was reported for 71.6% and 28.4% of patients, respectively. Overall, 95.6% of patients had adenocarcinomas and histological stage at diagnosis was stage IV for 79.8% of patients. EGFR mutations were identified mainly on exon 19 (46.5%) and exon 21 (40.4%). A geriatric assessment was performed in 35.1% of patients. TKI treatment was administered to 97.3% of patients as first or second line of treatment. Overall response rate and disease control rate were 63.3% (69/109) and 78.9% (86/109), respectively. Median progression-free survival was 11.9 months (95% confidence interval [CI], 8.6–14.7) and median overall survival was 20.9 months (95% CI, 14.3–27.1). After progression, 36/95 (37.9%) patients received a new line of chemotherapy. Main toxicities were cutaneous for 66.7% of patients (grade 3–4, 10%), diarrhea for 56.0% (grade 3–4, 15%; grade 5, 2%) and others for 25.7% (grade 3–4, 41%).Conclusions. Octogenarians with EGFR-mutated NSCLC treated by EGFR TKI had clinical outcomes and toxicity profile comparable to younger patients. Geriatric assessment appeared to be underused in this population.

Keywords: elderly; tyrosine-kinase inhibitors; Gerotarget; non-small cell lung cancer; EGFR; targeted therapies

Domains: Life Sciences [q-bio]; Cancer; Chemical Sciences

Romain Corre, Radj Gervais, Florian Guisier, Louis Tassy, Florent Vinas, et al.. Octogenarians with EGFR-mutated non-small cell lung cancer treated by tyrosine-kinase inhibitor a multicentric real-world study assessing tolerance and efficacy (OCTOMUT study). Oncotarget, 2018, 9 (9), pp.8253-8262. ⟨10.18632/oncotarget.23836⟩. ⟨hal-01744405⟩