Objectives: Molecular diagnostics and care of non-small cell lung cancer (NSCLC) are continuously evolving. Few data document the current strategies to manage advanced NSCLC patients beyond progression in clinical practice. Patients and methods: Be-TeaM is an Italian multi-center observational study conducted on consecutive EGFR-mutated stage IV NSCLC patients, progressed during/after a first-line EGFR-TKI. It consists of a retrospective phase, from first-line EGFR-TKI therapy start until study entry (i.e. beginning of the diagnostic process), and a prospective phase, until treatment choice or for 3 months if no therapy was prescribed. Primary objective was to describe the diagnostic and therapeutic approaches adopted after progression in a real-world setting. Results: Of 308 patients enrolled in 63 centers from July 2017 to June 2018, 289 were included in the analysis. In first line, 53.3 % received gefitinib, 32.5 % afatinib and 14.2 % erlotinib. The testing rate (i.e. rate of all patients undergone any biopsy -liquid and/or tissue- for the T790 M detection) was 90.7 %, with liquid biopsy being the most frequently executed. Of 262 biopsied patients, 64.5 % underwent only 1 liquid biopsy, 10.7 % only 1 tissue biopsy and 18.3 % >1 biopsy, both liquid and solid in 85.4 %. The T790M positivity rate was 45.3 %; of 166 patients undergone only a liquid biopsy and tested for the mutation, 39.8 % were T790M+ and 60.2 % T790M-/undetermined. By the observation end, 87.9 % patients had a post-progression treatment chosen, osimertinib being the most frequent among the T790M+. Conclusion: Be-TeaM provides the first snapshot of current practices for the management of NSCLC patients beyond progression in Italy; in clinical practice, assessing the T790M status is not always feasible.

Be-TeaM: An Italian real-world observational study on second-line therapy for EGFR-mutated NSCLC patients / Reale, M. L.; Chiari, R.; Tiseo, M.; Vitiello, F.; Barbieri, F.; Cortinovis, D.; Ceresoli, G. L.; Finocchiaro, G.; Romano, G. D.; Piovano, P. L.; Del Conte, A.; Borra, G.; Verderame, F.; Scotti, V.; Nonnis, D.; Galetta, D.; Sergi, C.; Migliorino, M. R.; Tonini, G.; Cecere, F.; Berardi, R.; Pino, M. S.; Martelli, O.; Gelibter, A.; Carta, A.; Vattemi, E.; Pagano, M.; Zullo, A.; Ferrari, S.; Rossi, A.; Novello, S.. - In: LUNG CANCER. - ISSN 0169-5002. - 140(2020), pp. 71-79. [10.1016/j.lungcan.2019.12.006]

Be-TeaM: An Italian real-world observational study on second-line therapy for EGFR-mutated NSCLC patients

Tiseo M.;
2020

Abstract

Objectives: Molecular diagnostics and care of non-small cell lung cancer (NSCLC) are continuously evolving. Few data document the current strategies to manage advanced NSCLC patients beyond progression in clinical practice. Patients and methods: Be-TeaM is an Italian multi-center observational study conducted on consecutive EGFR-mutated stage IV NSCLC patients, progressed during/after a first-line EGFR-TKI. It consists of a retrospective phase, from first-line EGFR-TKI therapy start until study entry (i.e. beginning of the diagnostic process), and a prospective phase, until treatment choice or for 3 months if no therapy was prescribed. Primary objective was to describe the diagnostic and therapeutic approaches adopted after progression in a real-world setting. Results: Of 308 patients enrolled in 63 centers from July 2017 to June 2018, 289 were included in the analysis. In first line, 53.3 % received gefitinib, 32.5 % afatinib and 14.2 % erlotinib. The testing rate (i.e. rate of all patients undergone any biopsy -liquid and/or tissue- for the T790 M detection) was 90.7 %, with liquid biopsy being the most frequently executed. Of 262 biopsied patients, 64.5 % underwent only 1 liquid biopsy, 10.7 % only 1 tissue biopsy and 18.3 % >1 biopsy, both liquid and solid in 85.4 %. The T790M positivity rate was 45.3 %; of 166 patients undergone only a liquid biopsy and tested for the mutation, 39.8 % were T790M+ and 60.2 % T790M-/undetermined. By the observation end, 87.9 % patients had a post-progression treatment chosen, osimertinib being the most frequent among the T790M+. Conclusion: Be-TeaM provides the first snapshot of current practices for the management of NSCLC patients beyond progression in Italy; in clinical practice, assessing the T790M status is not always feasible.
Be-TeaM: An Italian real-world observational study on second-line therapy for EGFR-mutated NSCLC patients / Reale, M. L.; Chiari, R.; Tiseo, M.; Vitiello, F.; Barbieri, F.; Cortinovis, D.; Ceresoli, G. L.; Finocchiaro, G.; Romano, G. D.; Piovano, P. L.; Del Conte, A.; Borra, G.; Verderame, F.; Scotti, V.; Nonnis, D.; Galetta, D.; Sergi, C.; Migliorino, M. R.; Tonini, G.; Cecere, F.; Berardi, R.; Pino, M. S.; Martelli, O.; Gelibter, A.; Carta, A.; Vattemi, E.; Pagano, M.; Zullo, A.; Ferrari, S.; Rossi, A.; Novello, S.. - In: LUNG CANCER. - ISSN 0169-5002. - 140(2020), pp. 71-79. [10.1016/j.lungcan.2019.12.006]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2872426
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