Safety And Efficacy of Osimertinib As A Therapy In Patients With Egfr T790M Positive Non Small Cell Lung Cancer Patients: A Systematic Review

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide, and Non-small cell lung cancer (NSCLC) accounts for approximately 85 % of all lung cancers. In recent years, it has been well known that NSCLC patients with mutations of epidermal growth factor receptor (EGFR) response better to EGFR-tyrosine kinase inhibitor treatment. Osimertinib is a part of series of small-molecule inhibitors developed to target EGFR mutant forms that are resistant to first- and second-generation EGFR TKIs Clinical trials which included Osimertinib as an intervention for patients with EGFRm T790M advanced NSCLC, were identified in databases such as, Cochrane, and MEDLINE (via PubMed). No language and publication year restrictions were applied. Two researchers independently reviewed studies using the Cochrane methodology for systematic reviews. Outcomes of interest included progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety. In total, 147 potentially relevant studies were screened. Three clinical trials involving 830 patients with EGFRm T790M advanced NSCLC were included.Two trials were single arm studies and 1 randomized controlled trial. Overall, 690 patients received Osimertinib and 140 received other drugs. The response rate was significantly better in the osimertinib group (71%; 95% CI, 65 to 76) than in the platinum–pemetrexed group (31%; 95% CI, 24 to 40). Osimertinib provided a high objective response rate (ORR) and progression-free survival (PFS) in single arm studies. Overall, longer duration of progression-free survival was observed with Osimertinib. Very few patients were reported with adverse events of grade 3 or higher. Osimertinib is an important treatment option for patients with T790M-positive advanced non-small-cell lung cancer. Provides good clinical activity with minimal side-effects in patients with EGFRThr790Met-positive NSCLC. However, the results have to be interpreted cautiously due to limited number of trials available.