Concomitant aspirin with osimertinib offers PFS benefit in EGFR-mutant NSCLC

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with advanced epidermal growth factor receptor (EGFR)-mutant NSCLC who took aspirin while undergoing treatment with osimertinib had significantly better PFS than those who did not take aspirin.

Why this matters

  • Studies have suggested a protective benefit of aspirin against incidence, metastasis, or death from certain types of cancer, but its effect on EGFR-positive NSCLC is understudied.

Study design

  • 365 patients with advanced EGFR-mutant NSCLC treated with osimertinib, 77 of whom received concomitant aspiring for ≥1 month.
  • Funding: University of Texas MD Anderson Cancer Center.

Key results

  • Patients in the aspirin group had a lower incidence of central nervous system (CNS) metastases before osimertinib treatment (27% vs 43%; P=.013) and were older (median age, 69 vs 62 years; P<.001>
  • Median PFS was significantly longer in the aspirin group (HRs):
    • Overall (21.3 vs 11.6 months): 0.52 (P<.001>
    • With first-line osimertinib: 0.35 (P=.007).
    • With second- or later-line osimertinib: 0.50 (P=.002).
    • Among those with CNS metastases: 0.43 (P=.006).
    • Among those without CNS metastases: 0.50 (P=.005).
  • Median OS was also longer in the aspirin group: 0.56 (P=.049).
  • PFS benefit was found regardless of age, sex, or EGFR mutation type.

Limitations

  • Retrospective, single-center study.