Real-world study of afatinib in first-line or re-challenge settings for patients with EGFR mutant non-small cell lung cancer

Afatinib, a second-generation epidermal growth factor receptor (EGFR)—tyrosine kinase inhibitor (TKI) for mutant non-small cell lung cancer (NSCLC), was approved in Japan in 2014. This study evaluated clinical outcomes of afatinib in real-world practice. Medical records of patients who received afat...

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Veröffentlicht in:Medical oncology (Northwood, London, England) London, England), 2019-06, Vol.36 (6), p.57-8, Article 57
Hauptverfasser: Tanaka, Hisashi, Taima, Kageaki, Itoga, Masamichi, Ishioka, Yoshiko, Baba, Keisuke, Shiratori, Toshihiro, Sakamoto, Hiroaki, Tsuchiya, Junichiro, Nakagawa, Hideyuki, Hasegawa, Yukihiro, Yasugahira, Hideo, Okudera, Koichi, Takanashi, Shingo, Tasaka, Sadatomo
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Sprache:eng
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Zusammenfassung:Afatinib, a second-generation epidermal growth factor receptor (EGFR)—tyrosine kinase inhibitor (TKI) for mutant non-small cell lung cancer (NSCLC), was approved in Japan in 2014. This study evaluated clinical outcomes of afatinib in real-world practice. Medical records of patients who received afatinib for advanced EGFR-mutant NSCLC were retrospectively reviewed. In total, 128 patients were analyzed. Seventy-six patients received afatinib as the first-line setting and 52 as the re-challenge setting (i.e., after failure of prior first-generation TKI). There was no difference in patient characteristics, such as age, sex, and PS, between the first-line and the re-challenge settings. In the first-line setting, the median progression-free survival (PFS) was 17.8 months (95% confidence interval [CI] 13.7–21.5 months). The overall survival (OS) was 39.5 months (95% CI 34.4- not reached). The response rate (RR) was 64.4%. Subset analysis indicated that patients with dose reduction showed longer PFS than those without dose reduction (18.5 months versus 7.9 months) ( P  = 0.016). In the re-challenge setting, the median PFS was 8.0 months (95% CI 4.9–9.5 months). The RR was 25%. Most common adverse events leading to dose modification or treatment discontinuation included diarrhea, paronychia, and oral mucositis in both settings. Interstitial lung disease occurred in 5.4% (7/128). In the real-world practice in Japan, afatinib showed comparable or better efficacy compared with that shown in previous clinical trials in both the first-line and the re-challenge settings.
ISSN:1357-0560
1559-131X
1559-131X
DOI:10.1007/s12032-019-1278-9