What question did this study set out to answer?

This research aims to evaluate the effectiveness of ABCP compared to standard chemotherapy in patients with EGFR-mutant NSCLC after EGFR-TKI treatment, focusing on PD-L1 expression.

April 5, 2026

Abstract 5238: Retrospective study for clinical biomarkers to guide post-EGFR-TKI treatment strategies in EGFR-mutant NSCLC

Key Points

This research aims to evaluate the effectiveness of ABCP compared to standard chemotherapy in patients with EGFR-mutant NSCLC after EGFR-TKI treatment, focusing on PD-L1 expression.
Conducted a multicenter retrospective study involving 408 patients with advanced EGFR-mutant NSCLC.
Patients received either platinum-based chemotherapy or ABCP after EGFR-TKI treatment.
Propensity score matching was used to adjust for baseline characteristics in outcomes evaluation.
No significant differences in progression-free survival (PFS) or overall survival (OS) between the chemotherapy and ABCP groups.
In patients with PD-L1 expression ≥50%, the ABCP group demonstrated significantly longer PFS.

Abstract

Abstract Background: In patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations, the combination of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) has demonstrated encouraging efficacy following prior treatment with EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, real-world evidence comparing ABCP with standard platinum-based chemotherapy remains unclear. Methods: We conducted a multicenter retrospective study including 408 patients with advanced or recurrent EGFR-mutant NSCLC who received either platinum-based chemotherapy (with or without bevacizumab) or ABCP after EGFR-TKI treatment at 20 institutions in Japan. Clinical outcomes were evaluated using propensity score matching to adjust for baseline characteristics. Results: After propensity score matching, there were no significant differences in progression-free survival (PFS) or overall survival (OS) between the Chemo/Chemo + BEV and ABCP groups (median PFS, p = 0.44; median OS, p = 0.84). In the subgroup of patients with programmed death-ligand 1 (PD-L1) expression ≥50%, the ABCP group exhibited significantly longer PFS compared with the Chemo/Chemo + BEV group (p = 0.02). Conclusions: Among patients with EGFR-mutant NSCLC previously treated with EGFR-TKIs, those with high PD-L1 expression may derive greater benefit from ABCP therapy compared with platinum-based chemotherapy, suggesting that ABCP could represent a more promising treatment option in this subgroup. Citation Format: Tadaaki Yamada, Kenji Morimoto, Naoki Furuya, Hisashi Tanaka, Akihiro Yoshimura, Tomohiro Oba, Makoto Hibino, Takahito Fukuda, Yasuhiro Goto, Akira Nakao, Shinsuke Ogusu, Yuta Okazaki, Taishi Harada, Takayo Ota, Ken Masubuchi, Tae Hata, Koji Mikami, Shoki Matsumoto, Ryoichi Honda, Koji Date, Yusuke Chihara, Koichi Takayama. Retrospective study for clinical biomarkers to guide post-EGFR-TKI treatment strategies in EGFR-mutant NSCLC abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5238.

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