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Real-World Data Reinforces Survival Benefit of Sequential Gilotrif, Tagrisso in EGFR-Mutated NSCLC

NEW YORK – Treatment with afatinib (Boehringer Ingelheim's Gilotrif) followed by osimertinib (AstraZeneca's Tagrisso) appears to extend survival in patients with advanced, EGFR-mutated non-small cell lung cancer who have become resistant to first-line afatinib, according to a study published in Future Medicine last week. 

The retrospective real-world data analysis occurred within the global GioTag study and focused on a US cohort of 129 patients. Patients with advanced or metastatic NSCLC had to have common EGFR mutations and received first-line afatinib. Those who became resistant due to an acquired EGFR T790M mutation then received osimertinib. The researchers scanned patients' electronic medical records to enroll them into the study.

Among the patients with advanced NSCLC who were treated with first-line afatinib followed by osimertinib, the median overall survival was nearly four years and median time-to-treatment-failure — the study's primary endpoint — was 28.4 months. Patients received treatment with afatinib for an average of 11.3 months followed by osimertinib for an average of 15 months.

These results are consistent with previously reported analyses from the GioTag study. Data from the full, multi-country patient population will be reported later this quarter. 

"Developing resistance to EGFR [tyrosine kinase inhibitors] is, unfortunately, an expected outcome for many people with this specific lung cancer, and strategies for sequencing treatments continue to evolve with the use of TKIs in clinical practice," Balazs Halmos, chief of thoracic and head and neck oncology at Montefiore Medical Center, said in a statement. "These real-world data provide further insight into the overall survival associated with afatinib and subsequent osimertinib treatment and reinforce that previous findings may have application in the US treatment setting for patients with T790M acquired resistance."