The results of the first multicenter observational study reporting the outcomes of therapies of patients with epidermal growth factor receptor (EGFR)-positive non-small cell lung cancer in a “real-life Caucasian EGFR-mutated population” have been released, and they highlight the need for further research about new treatment strategies in this patient population.1

Response rates to first-line treatment with EGFR tyrosine kinase inhibitors decline after 9 to 12 months as patients develop resistance. No optimal therapy has been established as a second-line option.

Investigators sought to describe the percentage of EGFR-mutated patients who progressed to second-line therapy after treatment with EGFR tyrosine kinase inhibitors, assessing the type, objective response rate, progression-free and overall survival, and safety of second-line treatment. The study’s second objective was to determine the efficacy of first-line treatment.

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A total of 312 patients were included in the study. EGFR exon 19 deletion and L858R were the most common mutations, occurring in 59.6% and 31.1% of patients, respectively.

A total of 274 patients (95.1%) received any form of second-line therapy, including best supportive care. One hundred sixty-three patients received second-line systemic therapy with an overall response rate of 20.9% (95% CI, 14.62 – 27.10), a median progression-free survival and overall survival of 4.7 (95% CI, 3.81 – 5.26) and 24.5 (95% CI, 21.65 – 27.37) months, respectively.

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In regard to safety, grade 3–4 hematological and non-hematological toxicities were reported in 9% and 6.3% of 144 patients treated with chemotherapy while non-hematological toxicity was reported in 4 cases of the 17 patients receiving second-line targeted therapies. 


  1. Vavalà T, Follador A, Tiseo M, et al. BE-POSITIVE: beyond progression after tyrosine kinase inhibitor in EGFR- positive non small cell lung cancer patients [article in press]. Lung Cancer. doi: 10.1016/j.lungcan.2016.02.011.