Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Lung Neoplasms

Carcinoma, Non-Small-Cell Lung

Carcinoma

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Carcinoma, Bronchogenic

Bronchial Neoplasms

Antineoplastic Agents

All Drugs and Chemicals

Micronutrients

Hematinics

Vitamins

Amino Acids

Osimertinib

Carboplatin

Pemetrexed

Cisplatin

Mitogens

Enzyme Inhibitors

Folic Acid

Vitamin B Complex

Folic Acid Antagonists

Tyrosine Kinase Inhibitors

Protein Kinase Inhibitors

Folinic Acid

Folate

Vitamin B9

Tyrosine

First-line treatment = osimertinib, 80 mg, oral, daily; Second-line treatment = platinum (carboplatin or cisplatin) + pemetrexed chemotherapy, prescribed as per institutional standards; Third-line treatment = osimertinib rechallenge, 80 mg, oral, daily.

Patients may enter the study at first-line treatment, second-line treatment, or third-line treatment. This is dependent on meeting the eligibility criteria.

Osimertinib First-Line

Platinum-based chemotherapy (carboplatin or cisplatin) and pemetrexed are prescribed as per institutional standards.

Platinum + Pemetrexed Chemotherapy Second-Line

Rechallenge with osimertinib, 80 mg, oral, daily

Osimertinib Third-Line

Mark Vincent, MD

Daniel Breadner, MD

Sophie Sun, MD

Puneet Bains, MD

Parneet Cheema, MD

Rosalyn Juergens, MD

Hamid Mithoowani, MD

Jeffrey Rothenstein, MD

Paul Wheatley-Price, MD

Susana Cheng, MD

Geoffrey Liu, MD

This phase II single-armed study will examine the clinical utility of retreating patients with osimertinib, in the third-line, following first-line treatment with osimertinib and second-line treatment with platinum and pemetrexed chemotherapy. The current standard of care for first-line Epidermal Growth Factor Receptor (EGFR) mutated Advanced Non-Small Cell Lung Cancer (aNSCLC) is osimertinib, followed by cytotoxic chemotherapy.

The repeat of osimertinib following previous treatment failure is investigational, although supported by scientific rationale. The dosing and scheduling of osimertinib follows its use in approved settings. The investigators examine its tolerability and efficacy in this setting to ensure osimertinib is a safe third-line option for patients with Epidermal Growth Factor Receptor mutated (EGFR+) Advanced Non-Small Cell Lung Cancer(aNSCLC).

Osimertinib Then Chemotherapy in EGFR-mutated Lung Cancer With Osimertinib Third-line Rechallenge

Retrospective/real-time analysis of EGFR (and other) mutations in Circulating Tumor Deoxyribonucleic acid (ctDNA) from all study subjects.

A comparison of the effects of duration on osimertinib during first-line treatment on post progression outcomes.

A comparison of the effects of duration on osimertinib during third-line treatment on post progression outcomes. This includes time from first rechallenge (third-line) dose of osimertinib until subsequent treatments, and progression free survival of subsequent treatments.

A comparison of the effects of duration on chemotherapy (second-line treatment) on post progression outcomes.

Changes to blood-based biomarkers will be analyzed and compared to objective response rate and disease control rate to see if there are predictors or associations with radiographic response.

Optional blood samples will be collected at various timepoints for analysis of key genetic markers.

Optional tumor samples will be collected at various timepoints for analysis of key genetic markers.

Optional blood samples will be collected at various timepoints for analysis of key proteomic markers.

Optional tumor samples and blood samples will be collected at various timepoints for analysis of key proteomic markers.

Optional serial biopsies will be collected at various timepoints and analyzed via molecular diagnostics for genetic alterations, and for the co-mutational context. Samples will be compared to Circulating Tumor Deoxyribonucleic Acid (ctDNA) samples.

Adverse events will be graded using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0).

Objective Response Rate will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Objective Response Rate is the percent of subjects with measurable disease with at least one visit response of complete response or partial response.

Progression Free Survival will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Progression Free Survival is the time from the first dose of osimertinib until the date of objective disease progression or death (by any cause in the absence of progression).

Duration of Response will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Duration of Response is the time from the date of first documented response until date of documented progression or death (in the absence of disease progression), in the third-line setting (osimertinib re-challenge).

Disease Control Rate will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Disease Control Rate is the percentage of subjects who have a best overall response of complete response or partial response or stable disease.

Tumor Shrinkage will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1).

Overall Survival is the time from the date of the first osimertinib dose rechallenge (third line setting), until death due to any cause.

Time to Treatment Failure is the time from first dose of osimertinib rechallenge (third-line setting), until the date of objective disease progression leading to the decision to proceed with the next line of systemic therapy, or permanently forego antineoplastic system therapy, or death (by any cause in the absence of progression).

The effects of osimertinib on health related quality of life will be measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30).

The EORTC QLQ-C30 is a questionnaire consisting of 30 items measuring subjects general cancer symptoms and functioning. Responses regarding function and symptoms are on a scale of 1 (not at all) to 4 (very much). Also included are questions about overall health and quality of life. Responses are on a scale of 1 (very poor) to 7 (excellent).

The effects of osimertinib on health related quality of life will be measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Lung Cancer 13 items (EORTC QLQ-LC13).

The EORTC QLQ-LC13 is a complementary questionnaire to the EORTC QLQ-C30, measuring lung cancer symptoms. Responses regarding symptoms are on a scale of 1 (not at all) to 4 (very much).

The effects of osimertinib on disease-related symptoms will be measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30).

The EORTC QLQ-C30 is a questionnaire consisting of 30 items measuring subjects general cancer symptoms and functioning. Responses regarding function and symptoms are on a scale of 1 (not at all) to 4 (very much). Also included are questions about overall health and quality of life. Responses are on a scale of 1 (very poor) to 7 (excellent).

The effects of osimertinib on disease-related symptoms will be measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Lung Cancer 13 items (EORTC QLQ-LC13).

The EORTC QLQ-LC13 is a complementary questionnaire to the EORTC QLQ-C30, measuring lung cancer symptoms. Responses regarding symptoms are on a scale of 1 (not at all) to 4 (very much).

Objective Response Rate in the atypical Epidermal Growth Factor Receptor (EGFR) mutation population will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), in both the first line and third line settings. Objective Response Rate is the percent of subjects with measurable disease with at least one visit response of complete response or partial response.

Progression Free Survival in the atypical Epidermal Growth Factor Receptor (EGFR) population will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), in both the first line and third line settings. Progression Free Survival is the time from the first dose of osimertinib until the date of objective disease progression or death (by any cause in the absence of progression).

Duration of Response in the atypical Epidermal Growth Factor Receptor (EGFR) population will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), in both the first line and third line settings. Duration of Response is the time from the date of first documented response until date of documented progression or death (in the absence of disease progression), in the third-line setting (osimertinib re-challenge).

Disease Control Rate in the atypical Epidermal Growth Factor Receptor (EGFR) population will be determined using investigator assessments according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), in both the first line and third line settings. Disease Control Rate is the percentage of subjects who have a best overall response of complete response or partial response or stable disease.

Time to Treatment Failure is the time from first dose of osimertinib, until the date of objective disease progression leading to the decision to proceed with the next line of systemic therapy, or permanently forego antineoplastic system therapy, or death (by any cause in the absence of progression). Time to treatment failure will be analyzed in the atypical Epidermal Growth Factor Receptor (EGFR) mutation population, in both the first line and third line settings.

Overall Survival is the time from the date of the first osimertinib dose, until death due to any cause. Overall Survival will be analyzed in the atypical Epidermal Growth Factor Receptor (EGFR) mutation population, in both the first line and third line settings.

Time to Treatment Failure is the time from first dose of osimertinib, until the date of objective disease progression leading to the decision to proceed with the next line of systemic therapy, or permanently forego antineoplastic system therapy, or death (by any cause in the absence of progression). Time to Treatment Failure will be analyzed in the atypical Epidermal Growth Factor Receptor (EGFR) mutation population, in both the first line and third line settings.

AstraZeneca

Mark Vincent

Medical Oncologist

Symptoms and General Pathology

Nervous System Diseases

Rare Diseases

Adenocarcinoma

Neoplasm Metastasis

Adenocarcinoma of Lung

Meningeal Carcinomatosis

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Neoplastic Processes

Meningeal Neoplasms

Central Nervous System Neoplasms

Nervous System Neoplasms

Lung Adenocarcinoma

Anti-Inflammatory Agents

Antiemetics

Gastrointestinal Agents

Dexamethasone

Dexamethasone acetate

Pemetrexed 15 mg was administered with dexamethasone 5 mg via intraventricular or via lumbar puncture. First, induction intrathecal chemotherapy, twice per week for 2 weeks; then consolidation intrathecal chemotherapy, once per week for 4 weeks; and maintenance intrathecal chemotherapy, once per month until disease progression or unmanageable drug-related toxicity.

Zhenyu Pan

Guozi Yang

Pemetrexed is one of the first-line chemotherapeutic agents for non-squamous non-small cell lung cancer (NSCLC). Since 2017, intrathecal pemetrexed has shown good efficacy for patients with leptomeningeal metastases from NSCLC. It has been recommended as the preferred drug for intrathecal chemotherapy by the Chinese Society of Clinical Oncology (CSCO) guidelines. Tyrosine kinase inhibitors (TKIs) play a promising role in treating non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations. An international multi-center clinical study published in 2019 confirmed that double dose of osimertinib showed significant improvement in leptomeningeal metastases from NSCLC with EGFR exon 19 deletion or exon 21 L858R/T790M mutation. It makes TKIs the mainstay of treatment for patients with EGFR-mutant NSCLC with leptomeningeal metastases. However, the choice of treatment after resistance to targeted therapy is a hot topic in clinical practice, with 78% of patients in the study above who responded to double-dose osimertinib still showing progression at the time of follow-up. The purpose of this study was to observe the safety and efficacy of intrathecal pemetrexed for leptomeningeal metastasis from lung adenocarcinoma that progressed after a double dose of a third-generation TKI such as osimertinib.

This study is a single arm, open and phase II clinical trial. Consecutive patients with leptomeningeal metastases from lung adenocarcinoma that progressed after a double dose of a third-generation TKI such as osimertinib are enrolled in this study. Concomitant regimen consisted of intrathecal chemotherapy (via lumbar puncture, pemetrexed 15 mg, plus dexamethasone 5 mg, twice a week for 2 weeks as an induction phase, followed by once a week for 4 weeks as a consolidation phase. Thereafter, the maintenance phase is once a month). The RANO proposal for response criteria of leptomeningeal metastasis was used to assess the clinical response in this study.

Intrathecal Pemetrexed for Leptomeningeal Metastasis From Lung Adenocarcinoma That Progressed After Osimertinib.

An Open-label, Single-arm, Phase II Trial of Intrathecal Pemetrexed for Leptomeningeal Metastasis From Lung Adenocarcinoma That Progressed After a Double Dose of Third-generation TKIs, Including Osimertinib

All individual participant data that underlie results in a publication will be available to other researchers.

The response assessment in neuro-oncology criteria (RANO) proposal for response criteria of leptomeningeal metastasis was used to assess the clinical response in this study.

NPFS was defined as time from the start of treatment until neurological progression or death. The neurological progression was determined based on the RANO proposal evaluation criteria which have been established and published on Neuro Oncol.

Survival time was recorded since the date of patient enrollment. All patients were followed up until death or the end of the study.

The incidence of treatment-related adverse events were measured for determining tolerability and safety. Adverse events (AEs) are evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE, version 4.03). Events of grade 3-5 are defined as moderate and severe adverse events.

Guangzhou Medical University

Professor

Afatinib

Oral afatinib 30 mg tablet once daily, continuously

Continuous treatment of afatinib 30mg tablet once daily in the absence of disease progression or unacceptable treatment-related toxicity, Investigator decision or patient decision to discontinue study treatment.

Ross Soo, MBBS

Afatinib, a first-in-class irreversible ErbB family blocker, is a 1st line treatment option for patients with advanced stage NSCLC harbouring sensitizing EGFR mutations. In randomized 1st line studies of afatinib at a standard dose of 40 mg daily versus standard of care, 28-53% of patients required a dose reduction due to adverse events (AE) induced by afatinib. The most common AEs are cutaneous and gastrointestinal (diarrhoea, dysphagia, and mucositis). Prevalence of diarrhoea in patients receiving 40 mg of afatinib, in 1st line phase II and III studies is as high as 90.0% (all grades of diarrhoea) and 14.4% (grade 3-4 diarrhoea). Another important gastrointestinal AE is mucositis, which presents in 51.9%-64.4% of patients treated with afatinib, with only 4.4%-8.3% of the cases being grade 3-4. Dose reduction tended to occur in patients who had higher initial afatinib plasma concentrations and led to decreases in the incidence and severity of afatinib-related AEs without affecting therapeutic efficacy. The incidence of gastrointestinal AEs could be decreased \>50% with proper afatinib dose reduction.

The effect of 1st line afatinib 30 mg daily in patients with EGFR mutation-positive NSCLC is unknown. We hypothesize that, in patients with EGFR mutation-positive NSCLC, 1st line afatinib treatment at 30 mg daily is tolerable with less gastrointestinal AEs and with a similar efficacy to standard dose afatinib.

This is a multi-country, multi-centre, study designed to collect clinical data and to evaluate efficacy and safety of patients treated with afatinib 30 mg at the Investigator's discretion.

All entered patients (i.e., patients that have been treated with the defined medication) will receive continuous treatment of afatinib in the absence of disease progression or meeting any other withdrawal criteria. All patients will visit Investigator at regular intervals for assessment of efficacy and safety as outlined in the Flow Chart for the first 7 cycles treatment. The Investigator will assess the patient at each visit. Tumour response and progression will be assessed using RECIST 1.1 at the Investigator site.

Observational Study of Afatinib 30 mg Daily

An Observational Study of Afatinib 30 mg Daily in Patients With Advanced Non-small Cell Lung Cancer (NSCLC) Harbouring Common EGFR Mutations Treated With Afatinib

To assess the effect of afatinib 30 mg daily at the Investigator's discretion on progression-free survival rate (PFSR) at month 6.

Boehringer Ingelheim

National University Hospital, Singapore

The recommended dose is 80 mg osimertinib once a day until disease progression or unacceptable toxicity according to the prescription information and clinical practice. It can be taken with or without food at the same time each day.

The results of phase III FLAURA study showed a significant PFS benefit for first-line Osimertinib versus standard EGFR-TKIs in patients with EGFR mutation-positive NSCLC, the median PFS was 18.9 months and 10.2 months, respectively. However, only 136 Chinese patients were enrolled in FLAURA study. The objectives of this study are to assess the efficacy and safety of Osimertinib in a real world setting in Chinese patients with locally advanced or metastatic, treatment naïve, epidermal growth factor receptor (EGFR) mutation-positive Non-Small Cell Lung Cancer (NSCLC).

Total of \~30 study sites are selected for conducting this observational study. Eligible patients will be prospectively and consecutively included. Therefore, the clinical practice in the selected patients group can represent the "real-world" situation in China, and the patient's medical record will be well documented and archived in those hospitals. All data defined in the protocol will be collected during the study and entered in the Electric Data Capture (EDC), being consistent to the patients' medical records.

The most important bias of the study is that patients' characteristics will affect the treatment duration, efficacy and safety, such as, higher proportion of patients with WHO PS 2\~3 enroll in the study will result in shorter TTD, poorer effectiveness and higher toxicities than expected. The \~30 sites are not randomly selected and potential selection bias exists. To minimize enrolment bias, the patients who are eligible and consent to participate in the current study will be enrolled consecutively as per protocol and without personal preference from investigators.

The self-selection bias may exit for the willingness and non-willingness participants. We'll try our best to discuss with the non-willingness participants to make sure the consistency/comparative between the willingness and non-willingness participants.

There could be a certain percentage of patients who would lost to follow up, it is unavoidable in clinical study, and is more common in real world study. We can minimize the bias by selecting the hospitals with normative and high-quality clinical practice, trying to collect the reason of lost to follow up and enhancing patient management during the follow up. The above bias is acceptable as this is a "real-world" study. Only descriptive analysis will be performed for the primary, secondary and exploratory objectives. No statistical comparisons between subgroups will be done.

Blood Sample Collection and Retention: about 10 mL Whole human blood samples will be collected using streck tube, sent to the NGS lab and plasma will be extracted for storage at -80℃. until test.

Tissue Sample Collection and Retention At baseline, fresh tissue samples (or cytological samples) will be collected or 6 slices of tissue sample olefin resections obtained from surgery or 10 slices of tissue samples olefin resection obtained from puncture biopsy will be provide to central laboratory for biomarker analysis. Before tissue sample olefin resection sent to central laboratory, a pathological quality should be conducted to ensure the percentage of tumor cells is greater than 10%. Tissue sample olefin resection will be labeled and put in a box and store at room temperature

First Line Osimertinib for EGFR Mutation-positive Non-Small Cell Lung Cancer in Real World Chinese Setting

A Prospective, National, Multi-centric, Non-interventional Study of First Line Osimertinib in Chinese Patients With Locally Advanced/Metastatic，EGFR Mutation-positive NSCLC in Real World Setting

Time to discontinuation (TTD), is defined as the time from the date of first dose of Osimertinib in this study until the date of Osimertinib discontinuation for any reason including disease progression, treatment toxicity, death or other reason as recorded in CRF. Subjects who are still on treatment at the time of analysis will be censored at the date of last dose received. Lost to follow-up patients will be censored at last documented contact with patient status "on treatment".

Progression-free survival (PFS), is defined as the time from the date of first dose of Osimertinib in this study until the date of disease progression as recorded in CRF or death (by any cause in the absence of progression) regardless of whether the subject withdraws from therapy or receives another anti-cancer therapy prior to progression, which usually refer to Response Evaluation Criteria In Solid Tumours (RECIST) in clinical practice. Subjects who have not progressed or died at the time of analysis will be censored at the time of the latest date of assessment. If the subject has no evaluable visits after the baseline visit, they will be censored at 0 days unless they die before the planned visit after the baseline visit. Lost to follow-up patients who have not progressed will be censored at last documented contact with patient status "non-progression".

Progression-free survival rate (PFS rate), is defined as the percentage of patients who do not progress on Osimertinib treatment

Objective Response Rate (ORR), is defined as the percentage of patients with complete response or partial response by investigator assessment as recorded in the CRF, which usually refer to Response Evaluation Criteria In Solid Tumours (RECIST) in clinical practice.

Disease Control Rate (DCR), is defined as the percentage of patients with non-progression by investigator assessment as recorded in the CRF, which usually refer to Response Evaluation Criteria In Solid Tumours (RECIST) in clinical practice.

Defined as the proportion of patients who are still alive at a particular time in the study (eg, 1 year or 2 years). The patient should be contacted 1 week after the termination of the corresponding OS analysis data to determine survival status. Lost to follow-up patients who have not progressed will be censored at last documented contact with patient status "survival".

The mutation rate of de novo T790M test by high sensitive technique (analyzed by Next Generation Sequencing platform).

de novo T790M

Incidence of Adverse Events (AEs): Nature, incidence, severity and seriousness of adverse events, Incidence of Serious Adverse Events (SAEs), which usually be graded by CTCAE v4.03 based on current clinical practice.

First Affiliated Hospital of Zhejiang University

Gefitinib

Fiona Blackhall, MBCHB FRCP

The purpose of this study is to understand real world gefitinib usage patterns, patient characteristics and outcomes and to present these for a Caucasian population

A multicentre, retrospective chart review study to characterise gefitinib usage and outcomes in routine treatment

Gefitinib Usage and Outcomes in Routine Treatment

A Multicentre, Retrospective Chart Review Study to Characterise Gefitinib Usage and Outcomes in Routine Treatment

Retrospective population \[2009 to 2013\]

Intra-pemetrexed plus third-generation small molecule TKI drugs (e.g. 'osimertinib')

Third-generation small molecule TKI drugs (e.g. 'osimertinib') alone

Double-dose of TKI (e.g. 'osimertinib' 160 mg) was administered orally once daily until disease progression or unmanageable drug-related toxicity.

Intrathecal chemotherapy is one of the mainstay treatment options for leptomeningeal metastases. Pemetrexed is one of the first-line chemotherapeutic agents for non-squamous non-small cell lung cancer (NSCLC). Since 2017, intrathecal pemetrexed has shown good efficacy for patients with leptomeningeal metastases from NSCLC. It has been recommended as the preferred drug for intrathecal chemotherapy by the Chinese Society of Clinical Oncology (CSCO) guidelines. Tyrosine kinase inhibitors (TKIs) play a promising role in the treatment of non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations. Due to its small molecule properties, it can effectively penetrate the central nervous system barrier and deliver an effective antitumor effect. An international multi-center clinical study published in 2019 confirmed that double-dose of osimertinib showed significant improvement in leptomeningeal metastases from NSCLC with EGFR exon 19 deletion or exon 21 L858R/T790M mutation. It makes TKIs the mainstay of treatment for patients with EGFR-mutant NSCLC with leptomeningeal metastases. However, whether third-generation small molecule TKI drugs (e.g. 'osimertinib') combined with intrathecal pemetrexed could benefit patients with LM from EGFR- mutant NSCLC remains undetermined.

The aim of this Study is to compare the effects of intra-pemetrexed Plus third-generation small molecule TKI drugs (e.g. 'osimertinib') versus third-generation small molecule TKI drugs alone in leptomeningeal metastasis from EGFR mutation positive NSCLC.

Intra-pemetrexed Plus Third-generation Small Molecule TKI Drugs (e.g. 'Osimertinib') Versus Third-generation Small Molecule TKI Drugs Alone for Leptomeningeal Metastasis From Epidermal Growth Factor Receptor Mutation-Positive Non-Small-cell Lung Cancer

A Clinical Trial of Intra-pemetrexed Plus Third-generation Small Molecule TKI Drugs (e.g. 'Osimertinib') Versus Third-generation Small Molecule TKI Drugs Alone for Leptomeningeal Metastasis From Epidermal Growth Factor Receptor Mutation-Positive Non-Small-cell Lung Cancer

The incidence of treatment-related adverse events were measured for determining tolerability and safety. Adverse events (AEs) are evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE, version 4.03).

Events of grade 3-5 are defined as moderate and severe adverse events.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Osimertinib Then Chemotherapy in EGFR-mutated Lung Cancer With Osimertinib Third-line Rechallenge	NCT04335292	Non-Small Cell ...	Osimertinib Fir... Platinum + Peme... Osimertinib Thi...	18 Years -	Lawson Health Research Institute
Intrathecal Pemetrexed for Leptomeningeal Metastasis From Lung Adenocarcinoma That Progressed After Osimertinib.	NCT06296745	Leptomeningeal ...	Pemetrexed	18 Years - 75 Years	Guangzhou Medical University
Observational Study of Afatinib 30 mg Daily	NCT04909073	Non-Small Cell ... Epidermal Growt...	Afatinib	18 Years - 99 Years	National University Hospital, Singapore
First Line Osimertinib for EGFR Mutation-positive Non-Small Cell Lung Cancer in Real World Chinese Setting	NCT04391283	Carcinoma, Non-...	Osimertinib	18 Years -	First Affiliated Hospital of Zhejiang University
Gefitinib Usage and Outcomes in Routine Treatment	NCT01818947	Lung Cancer		18 Years -	AstraZeneca
First Line Osimertinib for EGFR Mutation-positive Non-Small Cell Lung Cancer in Real World Chinese Setting	NCT04391283	Carcinoma, Non-...	Osimertinib	18 Years -	First Affiliated Hospital of Zhejiang University
Osimertinib Then Chemotherapy in EGFR-mutated Lung Cancer With Osimertinib Third-line Rechallenge	NCT04335292	Non-Small Cell ...	Osimertinib Fir... Platinum + Peme... Osimertinib Thi...	18 Years -	Lawson Health Research Institute
Intra-pemetrexed Plus Third-generation Small Molecule TKI Drugs (e.g. 'Osimertinib') Versus Third-generation Small Molecule TKI Drugs Alone for Leptomeningeal Metastasis From Epidermal Growth Factor Receptor Mutation-Positive Non-Small-cell Lung Cancer	NCT06304441	Leptomeningeal ...	Osimertinib Pemetrexed	18 Years - 75 Years	Guangzhou Medical University

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