First-line osimertinib in EGFR mutation-positive non-small cell lung cancer patients with poor performance status

Background: The efficacy of osimertinib as a first-line treatment for patients with poor performance status (PS) remains unclear. Patients & methods: This multicenter retrospective study evaluated patients treated with osimertinib between 2018 and 2020, with PS 2-4. Results: Among 36 patients with PS 2, the median progression-free survival (PFS), 1-year PFS, median overall survival (OS) and 1-year OS were 14.5 months, 65.4%, 18.1 months and 72.7%, respectively. Among 20 patients with PS 3-4, the median PFS, 1-year PFS, median OS and 1-year OS were 3.0 months, 27.1%, 5.0 months and 46.1%, respectively. Conclusion: Osimertinib was not as efficacious as other EGFR-tyrosine kinase inhibitors. Lay abstract Osimertinib is a first-line pharmacotherapy for patients with EGFR mutation-positive non-small cell lung cancer. However, the efficacy of osimertinib as a first-line treatment for patients with poor performance status (PS) remains unclear. This study evaluated 56 patients classified as PS 2, 3 and 4 (36, 14 and 6 patients, respectively) treated with osimertinib between 2018 and 2020. Osimertinib efficacy was lower than that of other EGFR-tyrosine kinase inhibitors. This study is the first to report using osimertinib as a first-line treatment in patients with poor PS.