Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers
Real-world evidence surrounding <i>EGFR</i> positive NSCLC patients in Canada is limited. Administrative databases in Alberta, Canada were used to evaluate <i>EGFR</i> testing and mutation prevalence in de novo metastatic NSCLC, as well as the characteristics, treatment patte...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/10/567 |
| _version_ | 1797473974898130944 |
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| author | Dylan E. O’Sullivan Tamer N. Jarada Amman Yusuf Leo (Xun Yang) Hu Priyanka Gogna Darren R. Brenner Erica Abbie Jennifer B. Rose Kiefer Eaton Julia Elia-Pacitti Emmanuel M. Ewara Aliyah Pabani Winson Y. Cheung Devon J. Boyne |
| author_facet | Dylan E. O’Sullivan Tamer N. Jarada Amman Yusuf Leo (Xun Yang) Hu Priyanka Gogna Darren R. Brenner Erica Abbie Jennifer B. Rose Kiefer Eaton Julia Elia-Pacitti Emmanuel M. Ewara Aliyah Pabani Winson Y. Cheung Devon J. Boyne |
| author_sort | Dylan E. O’Sullivan |
| collection | DOAJ |
| description | Real-world evidence surrounding <i>EGFR</i> positive NSCLC patients in Canada is limited. Administrative databases in Alberta, Canada were used to evaluate <i>EGFR</i> testing and mutation prevalence in de novo metastatic NSCLC, as well as the characteristics, treatment patterns, and outcomes of individuals with Exon 19, L858R and Exon20ins mutations. Between 2013–2019, 2974 individuals underwent <i>EGFR</i> testing, of which 451 (15.2%) were <i>EGFR</i> positive. Among <i>EGFR</i> positive individuals, 221 (49.0%) had an Exon 19 mutation, 159 (35.3%) had an L858R mutation, and 18 (4%) had an Exon20ins mutation. The proportion of individuals who initiated 1L systemic therapy was 89.1% for Exon19, 85.5% for L858R, and 72.2% for Exon20ins carriers. The primary front-line systemic therapy was gefitinib or afatinib monotherapy for individuals with Exon 19 (93.4%) and L858R (94.1%) mutations versus platinum combination therapy for individuals with Exon20ins mutations (61.5%). The Exon20ins cohort had worse median overall survival from initiation of 1L systemic therapy (10.5 months [95% CI: 8.0-not estimable]) than the Exon19 (20.6 months [95% CI: 18.4–24.9]), and L858R cohorts (19.1 months [95% CI: 14.5–23.1]). These findings highlight that Exon20ins mutations represent a rare subset of NSCLC in which treatment options are limited and survival outcomes are worse relative to individuals with more common types of <i>EGFR</i> mutations. |
| first_indexed | 2024-03-09T20:24:46Z |
| format | Article |
| id | doaj.art-edf5dbbb360b4f88b187a35e6a95da2f |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T20:24:46Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-edf5dbbb360b4f88b187a35e6a95da2f2023-11-23T23:40:13ZengMDPI AGCurrent Oncology1198-00521718-77292022-09-0129107198720810.3390/curroncol29100567Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation CarriersDylan E. O’Sullivan0Tamer N. Jarada1Amman Yusuf2Leo (Xun Yang) Hu3Priyanka Gogna4Darren R. Brenner5Erica Abbie6Jennifer B. Rose7Kiefer Eaton8Julia Elia-Pacitti9Emmanuel M. Ewara10Aliyah Pabani11Winson Y. Cheung12Devon J. Boyne13Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaOncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, CanadaOncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaJanssen Inc., Toronto, ON M3C 1L9, CanadaJanssen Inc., Toronto, ON M3C 1L9, CanadaJanssen Inc., Toronto, ON M3C 1L9, CanadaJanssen Inc., Toronto, ON M3C 1L9, CanadaJanssen Inc., Toronto, ON M3C 1L9, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaReal-world evidence surrounding <i>EGFR</i> positive NSCLC patients in Canada is limited. Administrative databases in Alberta, Canada were used to evaluate <i>EGFR</i> testing and mutation prevalence in de novo metastatic NSCLC, as well as the characteristics, treatment patterns, and outcomes of individuals with Exon 19, L858R and Exon20ins mutations. Between 2013–2019, 2974 individuals underwent <i>EGFR</i> testing, of which 451 (15.2%) were <i>EGFR</i> positive. Among <i>EGFR</i> positive individuals, 221 (49.0%) had an Exon 19 mutation, 159 (35.3%) had an L858R mutation, and 18 (4%) had an Exon20ins mutation. The proportion of individuals who initiated 1L systemic therapy was 89.1% for Exon19, 85.5% for L858R, and 72.2% for Exon20ins carriers. The primary front-line systemic therapy was gefitinib or afatinib monotherapy for individuals with Exon 19 (93.4%) and L858R (94.1%) mutations versus platinum combination therapy for individuals with Exon20ins mutations (61.5%). The Exon20ins cohort had worse median overall survival from initiation of 1L systemic therapy (10.5 months [95% CI: 8.0-not estimable]) than the Exon19 (20.6 months [95% CI: 18.4–24.9]), and L858R cohorts (19.1 months [95% CI: 14.5–23.1]). These findings highlight that Exon20ins mutations represent a rare subset of NSCLC in which treatment options are limited and survival outcomes are worse relative to individuals with more common types of <i>EGFR</i> mutations.https://www.mdpi.com/1718-7729/29/10/567non-small cell lung cancerepidermal growth factorgenomic testinghealthcare resource usereal world evidence |
| spellingShingle | Dylan E. O’Sullivan Tamer N. Jarada Amman Yusuf Leo (Xun Yang) Hu Priyanka Gogna Darren R. Brenner Erica Abbie Jennifer B. Rose Kiefer Eaton Julia Elia-Pacitti Emmanuel M. Ewara Aliyah Pabani Winson Y. Cheung Devon J. Boyne Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers Current Oncology non-small cell lung cancer epidermal growth factor genomic testing healthcare resource use real world evidence |
| title | Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers |
| title_full | Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers |
| title_fullStr | Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers |
| title_full_unstemmed | Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers |
| title_short | Prevalence, Treatment Patterns, and Outcomes of Individuals with <i>EGFR</i> Positive Metastatic Non-Small Cell Lung Cancer in a Canadian Real-World Setting: A Comparison of Exon 19 Deletion, L858R, and Exon 20 Insertion <i>EGFR</i> Mutation Carriers |
| title_sort | prevalence treatment patterns and outcomes of individuals with i egfr i positive metastatic non small cell lung cancer in a canadian real world setting a comparison of exon 19 deletion l858r and exon 20 insertion i egfr i mutation carriers |
| topic | non-small cell lung cancer epidermal growth factor genomic testing healthcare resource use real world evidence |
| url | https://www.mdpi.com/1718-7729/29/10/567 |
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