The natural history of this disease and the best systemic therapy options were unknown, especially in the era of osimertinib. Researchers found 54 patients with EGFR-mutated NSCLC with LM illness treated in academic oncology practice in Seattle, Washington, between January 3, 2000, and March 31, 2020. Investigators extracted demographic, tumor, therapy, and outcome data from the electronic medical record. The association between post-LM illness systemic therapy and overall survival was investigated using univariate Cox models. Student’s t-tests or a chi-squared test were used to analyze differences between groups in LM illness, natural history, and healthcare utilization. Patients given osimertinib before developing LM illness had a longer median time to diagnosis and a better performance status than those who were not. Patients who received any form of post-LM illness systemic medication had a decreased risk of death (HR 0.17, P<.001), suggesting that osimertinib-containing regimens result in longer median overall survival. Using the emergency room, hospital, or hospice was not linked to receiving post-LM illness systemic therapy. Prior osimertinib exposure appeared to impact the natural history of LM illness positively. After a diagnosis of LM illness, any systemic therapy was connected with longer survival and did not increase healthcare utilization. More research was needed to see if an osimertinib-containing regimen improves survival in patients with LM illness who had previously taken osimertinib. 

Source:www.clinical-lung-cancer.com/article/S1525-7304(22)00056-0/fulltext

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