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months (HR:0.40, p = 0.008). Subgroup analysis found that the PFS benefit of PC was evident in most subgroups excepting patients with brain metastasis. The 1-year overall survival rate of PC and PM were 89.0% and 78.3%, respectively. The ORR were 61.7% and 46.9% (p = 0.040), respectively. Conclusions: In patients with previously untreated, PD-L1≥50%, advanced NSCLC without EGFR or ALK mutations, the addition of pembrolizumab to standard platinum-based chemotherapy should be recommended as the preferred treatment.

Background: Non-small cell lung cancer (NSCLC) is the most frequent type of lung cancer that is associated with highest morbidity and mortality rate. Anlotinib is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase that is used as third-line treatment for NSCLC. The objective of this study was to evaluate the overall survival in patients with advanced NSCLC treated with anlotinib. Methods: Data was collected until January 5 th 2021 from PMC, PubMed, Google Scholar, Science Direct, and Scopus, using combination of keywords associated with advanced NSCLC and treatment using anlotinib in relation to their overall survival. Publications included are limited to English manuscripts that were published in the past 10 years. The studies include patients with advanced NSCLC and exclude patients with brain metastases that were controlled or uncontrolled for less than two months. All studies were reviewed and evaluated by authors. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS), with four studies were in moderate quality and one study was in good quality. Studies were also assessed using GRADE and showed moderate quality of evidence as there are neither inconsistency nor publication bias. Results: A total of five studies consisting of four clinical trial studies and one cohort study with a total of 1,353 advanced NSCLC patients were included. Studies claimed that anlotinib showed better PFS (HR = 0.48; 95% CI: 0,23-1.00; P = 0.05) and significantly improved OS (HR = 0.75; 95% CI: 0.67-0.83; P < 0.00001) compared to the placebo group. One study also presented better PFS and OS in refractory advanced NSCLC patients treated with anlotinib compared to the placebo group. Conclusions: Anlotinib is proven to be beneficial compared to placebo in treating advanced NSCLC patients as it shows significant improvement in overall survival and also better progression free survival. Studies also found that anlotinib possess remarkable efficacy and manageable safety profile, therefore should always be considered as candidate for treatment in advanced NSCLC.

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Background: RW data on PD pattern and safety of 1L osimertinib in EGFR mut aNSCLC are currently lacking. Methods: This is an observational, multicenter study enrolling EGFR mut aNSCLC receiving 1L osimertinib between November 2018 and 2020. Primary endpoints were treatment outcomes: median progression free survival (mPFS), time to treatment failure (mTTF) and PD patterns. Safety profile was also recorded as a secondary endpoint. PD was classified as isolated (single lesion PD), oligoprogression (oligoPD; PD in ≤ 3 lesions in ≤ 2 sites), systemic all others. Results: At data cut-off (January 5, 2021), 82 pts receiving osimertinib were included in 3 centres: 52 (63.4%) were female, 46 (56.1%) never smokers. Baseline EGFR mutations were exon 19 deletion in 39 (47.6%) pts, L858R in 36 (43.9%) pts, others in 7 (8.6%) pts. ECOG performance status was 0-1 in 65 (79.3%) pts. Number (N) of metastatic sites at diagnosis was <3 in 52 (63.4%) pts, ≥ 3 in 30 (35.6%) pts; 27 (32.9%) pts had brain metastases. Median follow-up was 11.2 months (mo). Response rate was 68.3%, disease control rate 86.6%. mPFS was 22.0 mo (95%CI, 11.4-32.5), mTTF 25.3 mo (95%CI, 18.9-not calculable). PD was reported in 28 (34%) pts; median N of PD sites was 2 (range 1-7); the most frequent PD sites were lung (N = 19, 67.9%), bone (N = 11, 39.3%) and brain (N = 7, 25%). New PD sites were present in 11 (39.3%) pts; median N = 1 (range 1-4). Isolated PD was observed in 5 (17.9%) pts, oligoPD in 6 (24.4%) and systemic in 16 (57.1%). 9 cases underwent tissue and/or liquid rebiopsy at PD. Druggable resistance mechanisms were identified in 5 pts: MET amplification (amp) (N = 3), MET amp/EGFR amp (N = 1) and HER2 amp (N = 1). The most frequent any grade (G) adverse events (AEs) were diarrhea (N = 33, 40.2%), rash (N = 32, 39.0%), paronychia (N = 22, 26.8%) and creatinine increase (N = 25, 30.5%). The most frequent G3/4 AEs were thromboembolic events (N = 6, 7.3%), diarrhea (N = 4, 4.9%), arterial thromboembolism (N = 2, 2.4%) and rash (N = 2, 2.4%). Conclusions: Osimertinib confirmed efficacy and safety in RW. Thromboembolic events were observed more frequently than previously reported. The study is still ongoing in order to recruit a larger patient population.