Three-Year Safety, Tolerability, and Health-Related Quality of Life Outcomes of Adjuvant Osimertinib in Patients With Resected Stage IB to IIIA EGFR-Mutated NSCLC: Updated Analysis From the Phase 3 ADAURA Trial


Por: John T., Grohé C., Goldman J.W., Shepherd F.A., de Marinis F., Kato T., Wang Q., Su W.-C., Choi J.H., Sriuranpong V., Melotti B., Fidler M.J., Chen J., Albayaty M., Stachowiak M., Taggart S., Wu Y.-L., Tsuboi M., Herbst R.S., Majem M.

Publicada: 1 ene 2023 Ahead of Print: 24 may 2023
Resumen:
INTRODUCTION: In ADAURA, adjuvant osimertinib significantly improved disease-free survival versus placebo in resected stage IB to IIIA EGFR-mutated NSCLC. We report in-depth analyses of three-year safety, tolerability, and health-related quality of life (HRQoL) from ADAURA. METHODS: Patients were randomized 1:1 to osimertinib 80 mg or placebo once daily for up to 3 years. Safety assessments were performed at baseline, week 2, week 4, week 12, and every 12 weeks until treatment completion or discontinuation, and 28 days after treatment was stopped. The SF-36 survey measured HRQoL at baseline, week 12, week 24, and every 24 weeks until recurrence, treatment completion or discontinuation. Data cutoff: April 11, 2022. RESULTS: Safety and HRQoL analysis sets: osimertinib, n = 337 and n = 339; placebo, n = 343 each. Median (range) total exposure duration was longer with osimertinib versus placebo: 35.8 (0-38) versus 25.1 (0-39) months. Most adverse events (AEs) were first reported within 12 months of starting treatment (osimertinib 97%, placebo 86%). AEs leading to dose reduction, interruption or discontinuation were reported in 12%, 27% and 13% respectively of patients with osimertinib; 1%, 13% and 3% with placebo. Stomatitis and diarrhea were the most common AEs leading to osimertinib dose reduction or interruption; interstitial lung disease was the most common leading to osimertinib discontinuation (per protocol). There were no differences in time to deterioration for SF-36 physical, mental component summaries between osimertinib and placebo. CONCLUSIONS: No new safety signals were reported and HRQoL was maintained with 3 years of adjuvant osimertinib treatment. Combined with significant efficacy benefit, these data further support adjuvant osimertinib in stage IB to IIIA EGFR-mutated NSCLC.

Filiaciones:
John T.:
 Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia

 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia

Grohé C.:
 Klinik für Pneumologie - Evangelische Lungenklinik Berlin Buch, Berlin, Germany

Goldman J.W.:
 David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States

Shepherd F.A.:
 Department of Medical Oncology and Hematology, University Health Network, Princess Margaret Cancer Centre and the University of Toronto, Toronto, ON, Canada

de Marinis F.:
 Thoracic Oncology Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy

Kato T.:
 Department of Thoracic Oncology, Kanagawa Cancer Center, Asahi Ward, Yokohama, Japan

Wang Q.:
 Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Su W.-C.:
 Department of Oncology, National Cheng Kung University, Tainan, Taiwan

Choi J.H.:
 Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea

Sriuranpong V.:
 Division of Medical Oncology, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Melotti B.:
 Division of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Fidler M.J.:
 Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL, United States

Chen J.:
 Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China

Albayaty M.:
 Oncology Research & Development, AstraZeneca, Cambridge, United Kingdom

Stachowiak M.:
 Late Oncology Research & Development, AstraZeneca, Warsaw, Poland

Taggart S.:
 Oncology Biometrics, AstraZeneca, Cambridge, United Kingdom

Wu Y.-L.:
 Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Tsuboi M.:
 Department of Thoracic Surgery and Oncology, National Cancer Center Hospital East, Kashiwa, Japan

Herbst R.S.:
 Medical Oncology, Yale School of Medicine and Yale Cancer Center, New Haven, CT, United States

Majem M.:
 Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
ISSN: 15560864
Editorial
ELSEVIER SCIENCE INC, STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 18 Número: 9
Páginas: 1209-1221
WOS Id: 001072190500001
ID de PubMed: 37236398
imagen hybrid, All Open Access; Hybrid Gold

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