What question did this study set out to answer?

To describe real-world treatment patterns and clinical outcomes in patients with advanced NSCLC after progression on osimertinib.

March 21, 2026Open Access

41P Safety of concurrent osimertinib (osi) and cranial radiotherapy (RT) in non-small cell lung cancer (NSCLC): Results from the phase IV SATIN trial

Key Points

To describe real-world treatment patterns and clinical outcomes in patients with advanced NSCLC after progression on osimertinib.
Retrospective analysis of 394 patients with EGFR-mutant NSCLC post 1L osimertinib progression.
Data collected from nine centers in China between January 2019 and December 2023.
Primary endpoint focused on treatment patterns and secondary endpoints included progression-free survival and overall survival.
Median progression-free survival for TKI-based regimens was 7.2 months, while chemotherapy showed 6.8 months.
MET amplification was identified as a prominent resistance mechanism in 20% of patients tested for molecular biomarkers.
3G TKI plus chemotherapy showed longer median progression-free survival (6.4 vs. 4.4 months) and median overall survival (17.3 vs. 11.9 months) compared to chemotherapy alone.

Abstract

Background: Osi is standard of care for treatment-nave EGFR-mutant advanced nonsmall cell lung cancer (NSCLC).However, the optimal treatment strategy after progression on osi remains unclear.This retrospective study described real-world disease characteristics, treatment patterns and clinical outcomes in post 1L osi progression setting to better understand variability in this scenario.Methods: Eligible pts included adults (18 year) with EGFRm advanced NSCLC who progressed on 1L osi between Jan 2019 and Dec 2023, and for whom 2L treatment data were available from nine centers in China.Primary endpoint was treatment patterns.Secondary endpoints included real-world progression free survival (rwPFS) and overall survival (OS) of different treatment regimens and safety.Data cutoff date was Nov 30, 2024.Results: A total of 394 pts were enrolled in the study.The median age was 62 years (range, 55-69), 55% pts were female, 87% had an ECOG PS of 0-1 and 40% had brain metastases.Molecular biomarkers testing was performed for 51% (201/394) pts, with MET amplification (20%, 41/201) identified as predominant resistance mechanism.2L treatment regimens were varied: TKI-based (56%, 220/394), chemo-based (31%, 122/394), IO-based (12%, 47/394) and other therapy (1%, 5/394), with median rwPFS 7.2 (95% CI: 5.9-8.2),6.8 (95% CI: 5.4-8.0),5.2 (95% CI: 3.9-8.6),6.5 (95% CI:4.5-11.8)months(mo) and median OS (mOS) ) mo, respectively.Among them, 12.7% (50/394) pts received 3G TKI plus chemotherapy (CTx) and 12.2% (48/394) received CTx alone.3G TKI plus CTx showed a numerically longer median rwPFS (6.4 vs. 4.4 mo) and mOS (17.3 vs. 11.9 mo) than CTx-alone.No new safety signals were observed in 2L treatment regimens. Conclusions:To our knowledge, this is the largest real-world study in China to understand 2L treatment patterns and clinical outcomes in post 1L osi progression setting.TKI-based therapy was the most common subsequent treatment patterns in real-world setting.3G TKI plus CTx may be an effective treatment strategy, further prospective validation is still required.Clinical trial identification: ChiCTR2500115193.

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