Real-world experience of afatinib as first-line therapy for advanced EGFR mutation-positive non-small cell lung cancer in Koreaopen access
- Authors
- Lee, Sung Yong; Choi, Chang-Min; Chang, Yoon Soo; Lee, Kye Young; Kim, Seung Joon; Yang, Sei Hoon; Ryu, Jeong Seon; Lee, Jeong Eun; Lee, Shin Yup; Park, Ji Young; Kim, Young-Chul; Oh, In-Jae; Jung, Chi Young; Lee, Sang Hoon; Yoon, Seong Hoon; Choi, Juwhan; Jang, Tae Won
- Issue Date
- 12월-2021
- Publisher
- AME PUBL CO
- Keywords
- Afatinib; epidermal growth factor receptor (EGFR); first-line; non-small cell lung cancer (NSCLC); real-world
- Citation
- TRANSLATIONAL LUNG CANCER RESEARCH, v.10, no.12, pp.4353 - +
- Indexed
- SCIE
SCOPUS
- Journal Title
- TRANSLATIONAL LUNG CANCER RESEARCH
- Volume
- 10
- Number
- 12
- Start Page
- 4353
- End Page
- +
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/144614
- DOI
- 10.21037/tlcr-21-501
- ISSN
- 2218-6751
- Abstract
- Background: We investigated the clinical characteristics and treatment outcomes of Korean patients receiving first-line afatinib for advanced epidermal growth factor receptor mutation-positive (EGFRm(+)) non-small cell lung cancer (NSCLC) in a real-world setting. Methods: Electronic case reports were retrospectively reviewed from patients across 15 sites in South Korea. Outcome measures included baseline characteristics, overall response rate (ORR), time-to-treatment discontinuation (TTD), and overall survival (OS). Subgroups were: presence/absence of brain metastases at baseline, dose reductions, and baseline EGFR mutation category. Results: Among 422 patients, 39.8% had brain metastases and 59.0%/25.1%/10.0%/5.0% had Del19/L858R/compound/uncommon EGFR mutations at baseline. ORR was 62.6% overall; responses were observed across all EGFR mutation categories, including against compound mutations. Median TTD was 17.8 months; median OS was not reached (NR). Median TTD and OS were longer in patients without versus with brain metastases (TTD: 22.9 vs. 14.8 months, P=0.001; OS: NR vs. 40.3 months, P=0.0009) and patients with versus without dose reductions (TTD: 22.2 vs. 14.2 months, P=0.0004; OS: NR vs. 40.3 months, P=0.0117). Median OS was 30.5/37.7 months in patients receiving chemotherapy/osimertinib as subsequent therapy. The most common treatment-related adverse events (TRAEs; any grade/grade >= 3) were diarrhea (31.3%/8.5%) and rash (23.0%/8.1%). Overall, 34 patients (8.1%) discontinued afatinib due to A Es. Conclusions: Afatinib was well tolerated with no new safety signals, and efficacy was encouraging in Korean patients with EGFRm(+) NSCLC, including those with baseline brain metastases and/or uncommon EGFR mutations. AE management with dose reductions facilitated a long TTD, prolonging the chemotherapy-free period for many patients.
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