Real-World Effectiveness of Osimertinib in Non-Small Cell Lung Cancer (NSCLC) with EGFR Mutation: Systematic Review and Meta-Analysis

Author(s)

Almutairi A¹, Alkhatib N², Maghaireh M², Halloush S³, Rashdan O⁴, Manasrah A⁵, Abraham I⁶, Almaaytah A⁷, Abumansour H², Saleh M⁸, Khassawaneh A⁹
¹Saudi Food and Drug Authority, Riyadh , Saudi Arabia, ²Al-Zaytoonah University, Amman, Jordan, ³Applied Science Private University, Amman, Jordan, ⁴Middle East University of Jordan, Amman, Jordan, ⁵Yarmouk University, Louisville , KY, USA, ⁶University of Arizona, Tucson, AZ, USA, ⁷Jordan University of Science and Technology, Irbid, Jordan, ⁸The University of Jordan, Amman, Jordan, ⁹Yarmouk University, Irbid, Jordan

Presentation Documents

ISPOR_POSTER_EPH133AA125923.pdf

OBJECTIVES: Osimertinib has been lunched in 2018 as an innovative tyrosine kinase inhibitor in the treatment of non-small cell lung cancer (NSCLC) that targets T790M mutations. The assessment of real-world effectiveness of osimertinib is lacking. This study aims to evaluate the real-world effectiveness of osimertinib in NSCLC.

METHODS: PubMed MEDLINE, Elsevier EMBASE, Cochrane Library and Google Scholar were systematically reviewed to collect real-world data on overall response rate (ORR), disease control rates (DCR), complete response (CR), partial response (PR), stable disease (SD), progressive disease PD); comparative hazard ratios for overall survival (OSHR) and progression-free survival (PFSHR); and AEs grade ≥3. A meta-analyses were performed for quantitatively estimated outcomes in single arm studies that assessed osimertinib and in two arms if osimertinib was compared to other alternatives. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Moreover, the study protocol was registered in the International Prospective Register of Systematic Reviews. The approval identification code is CRD42022328280.

RESULTS: In this study, 46 observational studies were included. Osimertinib showed an ORR of 57.3%(95%CI=52.6%, 61.9%); CR rate of 2.8%(95%CI=2.0%, 3.90%); PR rate of 55.3%(95%CI=49.9%, 60.6%); SD rate of 24.7%(95%CI=24.1%, 31.6%); PD rate of 9.1%(95%CI=6.0%, 13.6%). Osimertinib showed significant superiority over afatinib in terms overall survival and progression-free survival in T790M+ population; the OSHR was 0.60(95%CI=0.42, 0.86, P value=0.006); the PFSHR was 0.70(95%CI=0.53, 0.94, P value=0.016). The rate of occurrence of the most common AEs grade ≥3 was QT prolongation and was less than 2 percent among the included study population.

CONCLUSIONS: In general NSCLC population with T790M mutations, osimertinib was reasonably effective and safe. In terms of OSHR and PFHR, osimertinib was statistically superior over afatinib in NSCLC patients with T790 mutations.

Conference/Value in Health Info

2023-05, ISPOR 2023, Boston, MA, USA

Value in Health, Volume 26, Issue 6, S2 (June 2023)

Code

EPH133

Topic

Study Approaches

Topic Subcategory

Meta-Analysis & Indirect Comparisons

Disease

Drugs, Oncology

Presentation