EGFR-mutant NSCLC progressing on first-line osimertinib: rebiopsy in real-world and impact of second-line therapies (the ‘Rebiopsy on osi’ Study)

作者：Eleonora Gariazzo, Francesca Colamartini, Ornella Cantale, Andrea Mogavero, Antonio Vitale, Luca Romano, Marianna Peroni, Erika Rijavec, Marco Banini, S Mazzoni, Mirko Montrone, Giulia Pasello, Antonello Veccia, Francesca Rita Ogliari, Silvana Leo, D. Cortinovis, Angelo Delmonte, Lorenzo Belluomini, Giulia La Cava, Giulia Meoni, Claudio Sini, Marco Donatello Delcuratolo, Anna Bettin, Maria Pagano, Carlo Genova, A Russo, Giacomo Pelizzari, Luca Tondulli, Concetta Sergi, Roca El, Chiara Bennati, Salvatore Grisanti, Brigida Stanzione, Sabrina Mariotti, Tiziana Vavalà, Hector Soto Parra, Cinzia Ortega, Daniele Pignataro, Gaetano Lacidogna, Maria Simona Pino, Rita Chiari, Luana Calabrò, Daniele Pozzessere, Silvia Masini, Alain Gelibter, Scotti, Francesco Grossi, Marcello Tiseo, Emilio Bria, Giulio Metro · 发表于：The Oncologist · 年份：2026 · DOI：10.1093/oncolo/oyag285 · 研究领域：Lung Cancer Treatments and Mutations、Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment

BACKGROUND: Although rebiopsy at progression on osimertinib is recommended for patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC), its real-world impact on clinical outcomes remains unclear. Rebiopsy on Osi is a multicenter, retrospective study assessing rebiopsy patterns, resistance mechanisms, and their impact on second-line treatment choices and outcomes in routine clinical practice. METHODS: A total of 457 patients with advanced NSCLC harboring a common EGFR mutation (exon 19 deletion or L858R) who progressed on first-line osimertinib were identified from the Italian ATLAS registry. Patients were stratified according to rebiopsy status (tissue and/or plasma-based next generation sequencing) and receipt of biomarker-driven adaptive second-line therapy. RESULTS: Rebiopsy was performed in 206 patients (45.1%), predominantly via tissue sampling (66.2%). A resistance mechanism was identified in 80 cases (38.8%), with higher detection rates by tissue rebiopsy (46.6%) versus liquid (13.5%). MET amplification/overexpression emerged as the most frequent actionable resistance mechanism. Among 239 patients treated with second-line therapy, 39 (16.3%) received adaptive treatment, including 29 out of 39 patients (74.3%) with MET amplification/overexpression treated with a MET-TKI-based regimen. Median progression-free (PFS) and overall (OS) survival were longer with adaptive therapy (7.3 and 14.1 months) than with rebiopsy without treatment adaptation (6.5 and 12.2 ...