ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ OSIMERTINIB BƯỚC MỘT TRONG UNG THƯ PHỔI KHÔNG TẾ BÀO NHỎ GIAI ĐOẠN IV CÓ ĐỘT BIẾN EGFR TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objectives: Describe some clinical and subclinical characteristics and evaluate the results of first-line Osimertinib in stage IV non-small cell lung cancer with EGFR mutations at Hanoi Medical University Hospital. Patients and methods: 35 patients with stage IV non-small cell lung cancer with EGFR mutations were treated with first-line Osimertinib at the Oncology Center, Hanoi Medical University Hospital from June 2021 to December 2024. Results: The average age was 66 ± 8.9 years old, with the youngest being 45 years old and the oldest being 87 years old. The male/female ratio was almost equal. The majority of patients in the study had no smoking history (82.9%) and had comorbidities (73.5%). Patients in the study were mainly in good performance status, with PS 0 + 1 accounting for 71.5%, with 1 patient having PS 3. Adenocarcinoma was the most common pathology; The two common mutations were DEL 19 and L858R accounting for 57.1% and 34.3%, respectively. The overall response rate (partial + complete response) was 91%, the disease control rate (partial + complete response + stable disease) was 97% (complete response rate: 6%, partial response: 77%, stable disease: 14%, 3% of cases progressed). Analysis of the correlation between factors: gender, age, general health index and gene mutation type and response to Osimertinib treatment showed that the difference was not statistically significant. However, when analyzing the treatment response between the group of patients who smoked and did not smoke, the difference with p = 0.049 (<0.05) was statistically significant. The median progression-free survival was 18.1 months (95% confidence interval, 16.1 to 20.2 months); the shortest was 4 months and the longest was 30 months. Adverse events were commonly grade 1 and grade 2. The most common adverse events were rash and diarrhea, accounting for 54.2% and 51.3%, respectively. There was 1 patient with interstitial pneumonia due to Osimertinib. Conclusion: First-line treatment with Osimertinib is highly effective and well tolerated in patients with advanced non-small cell lung cancer with EGFR mutations.