107PThe real world experience of first generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI) in patients with advanced lung cancer: Explorative analysis of big data from national health insurance service of Korea

Background: Although the effectiveness of EGFR-TKI in patients with advanced lung cancer has been proven in previous trials, the real-world efficacy of EGFR-TKI has not been investigated. The object of this study was to evaluate the outcomes of first-generation EGFR-TKI in female patients with advanced lung cancer using big data analysis. Methods: We retrospectively reviewed the Korean health insurance service data of advanced lung cancer patients from January 2004 to December 2013. Patients older than 20 years in palliative setting were grouped into three categories: Group A received 1st-generation EGFR-TKI ≥6 months, group B given EGFR-TKI < 6 months, and group C was treated with cytotoxic chemotherapy alone. For each group, we determined progression-free survival (PFS) and overall survival (OS). Results: Of 11,045 patients enrolled in the study, 6,170 (55.8%) received EGFR-TKI at least 1 month, and 4,875 (44.2%) never treated with EGFR-TKI. 2,572 were in the group A and 3,598 were in the group B. In the group C, platinum based doublet agent or monotherapy such as docetaxel, gemcitabine and pemetrexed was administered. The median OS of patients treated with EGFR-TKI was significantly longer than that of EGFR-TKI naïve patients (19.1 months [95% confidence interval (CI) 18.5-19.7] vs 9.5 months [95% CI 9.1-9.8]; p < 0.0001). In subgroup analysis, the median OS was 30.3 months [95% CI 29.5-31.2] in the group A, compared with 12.3 months [95% CI 11.9-12.7] in the group B and 9.5 months [95% CI 9.1-9.8] in the group C (p < 0.001). Patients age < 65 years, treated with EGFR-TKI ≥ 6months, and received docetaxel, pemetrexed chemotherapy were independent predictors of longer OS (Hazard ratio (HR) 0.78 [95% CI 0.74-0.81]; p = 0.002, HR 0.41 [95% CI 0.38-0.43]; p < 0.001, HR 0.81 [95% CI 0.77-0.85]; p < 0.001, HR 0.77 [95% CI 0.74-0.81]; p < 0.001, respectively). Median PFS was 15.8 months [95% CI 15.1-16.3] in group A and 3.7 months [95% CI 3.5-3.8] in group B (p < 0.001). Conclusions: The current study demonstrated that EGFR-TKI conferred a significant PFS and OS benefit in female patient with advanced lung cancer in real-world. Legal entity responsible for the study: Asan Medical Center Funding: None Disclosure: All authors have declared no conflicts of interest.