Incidence of Bone Metastases and Skeletal-Related Events in Patients With EGFR-Mutated NSCLC Treated With Osimertinib

• Published in: JTO clinical and research reports 2023-05, Vol.4 (5), p.100513-100513, Article 100513
• Main Authors: Brouns, Anita J.W. M., van Veelen, Ard, Veerman, G. D. Marijn, Steendam, Christi, Dursun, Safiye, van der Leest, Cor, Croes, Sander, Dingemans, Anne-Marie C., Hendriks, Lizza E.L.
• Format: Article
• Language: English
• Subjects: Bone metastases related outcomes; Bone targeted agents; Lung adenocarcinoma; Original; Solid tumors; Tyrosine kinase inhibitor
• ISSN: 2666-3643; 2666-3643
• DOI: 10.1016/j.jtocrr.2023.100513

Bone metastases are frequent in patients with EGFR-mutated (EGFR+) NSCLC. Skeletal-related events (SREs) are common in these patients; however, no data on SRE in osimertinib-treated patients are reported. We investigated the development of bone metastases and SREs in patients with EGFR+ NSCLC treated with osimertinib. This is a retrospective multicenter cohort study that included patients with metastatic EGFR+ NSCLC who were treated with osimertinib between February 2016 and September 2021. Demographics, bone metastases-related outcomes, SREs, treatment efficacy, and overall survival (OS) were collected. In total, 250 patients treated with osimertinib (43% first line) were included. Of the patients, 51% had bone metastases at initiation of osimertinib. Furthermore, 16% of the patients with bone metastases used bone-targeted agents. Median follow-up from initiation of osimertinib was 23.4 months (95% confidence interval [CI]: 19.9–26.9 mo). During osimertinib treatment, 10% developed new bone metastases or bone progression. Of the patients with bone metastases, 39% had more than or equal to one SREs: 28% developed first SRE before osimertinib treatment, 1% after, and 11% during. Median OS post-bone metastasis was 30.8 months (95% CI: 21.9–39.7). Median OS after first SRE was 31.1 months (95% CI: 15.8–46.5). Bone metastases and SREs are frequent before and during treatment with osimertinib in EGFR+ NSCLC. Because of these findings and the long OS post-bone metastases, we advocate prescription of bone-targeted agents in these patients and recommend adding bone-specific end points in clinical trials.