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However, the efficacy of osimertinib in NSCLC patients with fluids, such as pleural, pericardial and abdominal effusions, is unclear. We evaluated the efficacy of osimertinib in this specific setting. NSCLC patients harboring <jats:italic>EGFR<\/jats:italic> T790\u00a0M mutations who experienced progressive disease after first EGFR-TKI treatment and started osimertinib treatment between April 2016 and August 2018 were retrospectively screened. In particular, we assessed the efficacy of osimertinib for NSCLC with <jats:italic>EGFR<\/jats:italic> T790\u00a0M mutations in patients who were diagnosed with <jats:italic>EGFR<\/jats:italic> T790\u00a0M mutation by malignant effusion. Among 90 patients with <jats:italic>EGFR<\/jats:italic> T790\u00a0M mutation who started osimertinib treatment after EGFR-TKI failure, 21 were diagnosed from malignant effusions excluding cerebrospinal fluid (F group) and 69 using other methods including tissue biopsies (NF group). Patient characteristics were well-balanced between the two groups. Overall response was 50%, and significantly worse in the F group (29%) than the NF group (57%; <jats:italic>P<\/jats:italic>\u00a0=\u20090.025). Median progression-free survival with osimertinib treatment in the F group (7.1\u00a0months, 95% confidence interval [CI]: 2.3\u201314.0) was significantly shorter than that in the NF group (11.9\u00a0months, 95% CI: 9.5\u201316.0; <jats:italic>P<\/jats:italic>\u00a0=\u20090.046)). Median drainage-free time was 10.9\u00a0months (95% CI: 1.4\u00a0months\u2013 not reached). The present study showed that the efficacy of osimertinib for NSCLC in which <jats:italic>EGFR<\/jats:italic> T790\u00a0M mutation is detected by malignant effusion may be less than in <jats:italic>EGFR<\/jats:italic> T790\u00a0M-mutated NSCLC detected by other methods.<\/jats:p>","DOI":"10.1007\/s10637-019-00808-1","type":"journal-article","created":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T07:19:12Z","timestamp":1560151152000},"page":"194-201","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Negative impact of malignant effusion on osimertinib treatment for non-small cell lung cancer harboring EGFR mutation"],"prefix":"10.1007","volume":"38","author":[{"given":"Takahisa","family":"Kawamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Kenmotsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Omori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Nakashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushige","family":"Wakuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tateaki","family":"Naito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruyasu","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,6,10]]},"reference":[{"issue":"1","key":"808_CR1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.20138","volume":"62","author":"R Siegel","year":"2012","unstructured":"Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. 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Haruki Kobayashi has received honoraria from Eli Lilly and Taiho Pharmaceutical. Kazuhisa Nakashima has received honoraria from Chugai Pharma, Boeringer Ingelheim and Novartis Pharma. Shota Omori has received personal fees from MSD K.K., Chugai Pharmaceutical, Boeringer Ingelheim, Ono Pharmaceutical, Taiho Pharmaceutical, and AstraZeneca. Kazushige Wakuda has received honoraria from AstraZeneca, Chugai Pharmaceutical, Boeringer Ingelheim, Eli Lilly, Taiho Pharmaceutical, Ono Pharmaceutical, and has received grant from AstraZeneca. Akira Ono has received honoraria from Chugai Pharmaceutical, Taiho Pharmaceutical, Ono Pharmaceutical, MSD K.K., Boehringer Ingelheim, and Novartis. Hirotsugu Kenmotsu has received honoraria from AstraZeneca, Chugai Pharmaceutical, Bristol-Myers, Boeringer Ingelheim, Eli Lilly, Kyowa Hakko Kirin, MSD K.K., Novartis Pharma, and grants from AstraZeneca, Chugai Pharmaceutical and Boehringer Ingelheim. Tateaki Naito has received honoraria from Ono Pharmaceutical. Masahiro Endo has received honoraria from AstraZeneca and Ono Pharmaceutical. Toshiaki Takahashi has received honoraria from Eli Lilly, AstraZeneca, Chugai Pharma, MSD, Ono Pharmaceutical, Roche Diagnostics, Boehringer Ingelheim, Pfizer and grants from Eli Lilly, AstraZeneca, Chugai Pharma, MSD, Pfizer and Ono Pharmaceutical. For the remaining authors no conflict interested are declared. All of the conflict of interest is outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of ethics"}}]}}