Assessing the Efficacy of Osimertinib in Patients With EGFR-Mutated Lung Cancer With Bone Metastases

Three patient case reports showed that osimertinib is a promising and viable treatment option for patients with advanced epidermal growth factor receptor (EGFR) 19 deletion-mutated lung adenocarcinoma and bone metastases. The results appeared in the journal Medicine.

As targeted therapies continue to advance, EGFR-tyrosine kinase inhibitors (TKIs) have become the mainstay treatment option for patients with advanced EGFR-mutated non-small cell lung cancer. Osimertinib, which is a third-generation EGFR-TKI, has been shown to be effective against exon 19 and 21 mutations, as well as the T790M mutation.

To assess the efficacy of osimertinib in treating patients with EGFR-mutated advanced lung adenocarcinoma and bone metastases, researchers analyzed the case reports of 3 patients. The patients had all received osimertinib treatment in recent years. They were female and aged 62, 62, and 54 years, respectively.

All 3 cases of interest involved patients with pulmonary adenocarcinoma as well as osseous metastases, and genetic testing revealed the presence of an EGFR 19del mutation. In the first case, the patient had undergone 17 months of gefitinib therapy but was switched to osimertinib following disease progression. The second patient had bone metastases after 20 months of pemetrexed-carboplatin chemotherapy, which led to a transition to osimertinib. In the third case, following 11 months of erlotinib treatment, the patient was diagnosed with bone metastases. Subsequently, that patient was administered radiation therapy, pemetrexed-carboplatin chemotherapy, pemetrexed-bevacizumab maintenance therapy, and docetaxel chemotherapy. When all interventions failed to stop bone metastasis, the patient was given a combination of osimertinib and anlotinib-targeted therapy.

The results of the study demonstrated that all 3 patients experienced robust and favorable survival outcomes, with a progression-free survival of 22.7 months, 12.0 months, and 17.7 months, respectively. “These cases suggest that osimertinib is a promising treatment option for patients with EGFR 19 deletion-mutated lung adenocarcinoma and bone metastases, although further clinical studies are needed to confirm its efficacy,” the researchers concluded.