Osimertinib as a Potential Targeted Therapy for Non-Small Cell Lung Carcinoma (NSCLC) Patients with EGFR Exon 20 T790M

Nur Zam Zam (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Harun Iskandar (Thoracal Oncology Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Nur Ahmad Tabri (Asthma and COPD Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Arif Santoso (Thoracal Oncology Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Nurjannah Lihawa (Infection and Tuberculosis Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Harry Akza Putrawan (Interventional Pulmonology Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245)
Ferry Sandra (Department of Biochemistry and Molecular Biology, Division of Oral Biology, Faculty of Dentistry, Universitas Trisakti, Jl. Kyai Tapa No. 260, Jakarta 11440,)

The Indonesian Biomedical Journal
Vol 15, No 5 (2023)

BACKGROUND: Emergence of drug resistance due to epidermal growth factor receptor (EGFR) Exon 20 T790M poses a challenge in the effective management of non-small cell lung carcinoma (NSCLC). Significant breakthrough in the management of NSCLC with a specific genetic alteration causes substantial condition improvement in patients whose cancer progressed after first-generation tyrosine kinase inhibitor treatment and who developed tumors with EGFR Exon 20 T790M mutation. The present study analyzed a cohort of NSCLC patients and investigated the incidence of the EGFR Exon 20 T790M status with Osimertinib therapy, along with its impact on survival rates.METHODS: This was a retrospective cohort study on 22 NSCLC subjects who were genetically examined for EGFR status from plasmic cell free total nucleic acid. Subjects with EGFR Exon 20 T790M mutation were treated with/without Osimertinib. Demographic and clinical data were descriptively summarized, and the differences of each variable and correlation between survival rate and EGFR Exon 20 T790M were analyzed.RESULTS: Subjects with (n=13) and without (n=9) EGFR Exon 20 T790M had survival rates of 10.77±2.45 and 4.78±1.48, respectively (p=0.000). Based on 1-year survival status of subjects with EGFR Exon 20 T790M, there were 3 Osimertinib-treated survivors and 2 Osimertinib-treated non-survivors. Eight subjects with EGFR Exon 20 T790M and without Osimertinib treatment did not survive (p=0.001).CONCLUSION: Since the treatment of Osimertinib demonstrated a noteworthy survival rate among NSCLC subjects with EGFR Exon 20 T790M, thus Osimertinib could be suggested as a potential targeted therapy for NSCLC subjects with EGFR Exon 20 T790M.KEYWORDS: non-small cell lung carcinoma, EGFR, Exon 20, T790M, osimertinib