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<b>Introduction:</b> The use of osimertinib in the first-line (1L) setting is an effective treatment option for sensitizing <i>EGFR</i>-mutations (<i>EGFR</i>m+) and has significantly altered the standard of care practice for <i>EGFR</i>m+ disease in Canada. Unfortunately, acquired resistance to osimertinib is almost universal, and outcomes are disparate. Post-progression treatment patterns and the outcome of real-world Canadian <i>EGFR</i>m+ patients receiving 1L osimertinib were the focus of this retrospective review. <b>Methods:</b> The Glans-Look Lung Cancer Research database was used to identify and collect demographic, clinical, treatment, and outcome data on <i>EGFR</i>m+ patients who received 1L osimertinib in the Canadian province of Alberta between 2018 and 2022. <b>Results:</b> A total of 150 patients receiving 1L osimertinib were identified. In total, 86 developed progressive disease, with 56 (65%) continuing systemic therapy, 73% continuing osimertinib, and 27% switching to second-line (2L) systemic therapy. Patients were similar both in clinical characteristics at 1L osimertinib initiation and patterns of treatment failure at progression; those continuing 1L osimertinib post-progression had a longer time to progression (13.5 vs. 8.8 months, <i>p</i> = 0.05) and subsequent post-osimertinib initiation survival (34.7 vs. 22.8 months, <i>p</i> = 0.11). <b>Conclusions</b>: The continuation of osimertinib post-progression is an effective disease management strategy for select real-world <i>EGFR</i>m+ patients, providing continued clinical benefit, potentially due to different underlying disease pathogenesis.