Overall survival of patients with EGFR mutation-positive non-small-cell lung cancer treated with erlotinib, gefitinib or afatinib under drug programmes in Poland - real-world data

Introduction: The aim of the study was to estimate the overall survival of patients with EGFR mutation-positive non-small-cell lung cancer treated with erlotinib, gefitinib or afatinib. Material and methods: Real-world patients who received afatinib, erlotinib or gefitinib between 1 July 2012 and 30 October 2017 were analysed in five subgroups. Results: Among 267 patients treated with afatinib financed as the first line of treatment, 76 ( 28.46%) deaths occurred. Median observation time was 12.8 months (95% CI: 11.2-13.9). Median OS was 22.8 months (95% CI: 19.2-27.1). Among 83 patients who received erlotinib financed exclusively as the second line of treatment the number of deaths was 74 (89.16%). Median observation time was 64.3 months (95% CI: 60.4-64.6). Median OS was 16 months (95% CI: 13.2-22.9). Among 622 patients who received erlotinib financed both as first and second line treatment, there were 400 (64.3%) deaths. Median observation time was 33.3 months (95% CI: 31.2-37.6). Median OS was 17.8 months (95% CI: 16.4-19.7). Among 137 patients who received gefitinib financed only as the first line of treatment, there were 128 (93.4%) deaths. Median observation time was 58.3 months (95% CI: 49.4-62.5). Median OS was 16 months (95% CI: 13.8-19.7). Among 348 patients who received gefitinib financed both as the first and second line of treatment the number of deaths was 208 (59.8%). Median observation time was 23.7 months (95% CI: 20.7-28.7). Median OS was 15.5 months (95% CI: 12.9-17.5). Conclusions: Our real-world data regarding OS confirm the benefits found in clinical trials from the use of afatinib, erlotinib or gefitinib. However, the lower overall survival rate of Polish patients compared to similar studies from other research centres suggests the need for deeper investigation of this issue.