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Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared with Gefitinib or Erlotinib.
Cancer Res Treat 2019; 51(2):502-509CR

Abstract

PURPOSE

We tried to evaluate whether there are any specific features in treatment outcomes of firstline afatinib in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), compared with gefitinib or erlotinib.

Materials and Methods

We analyzed patients treated with first-line afatinib, gefitinib, or erlotinib for advanced EGFR-mutant NSCLC at Samsung Medical Center between 2014 and 2016.

RESULTS

In total, 467 patients received first-line afatinib (n=165), gefitinib (n=230), or erlotinib (n=72). Afatinib was used more often in patients with tumors harboring deletion in exon 19 (Del19), whereas the gefitinib group had more elderly, females, and never smokers. The median progression-free survival (PFS) time for afatinib, gefitinib, and erlotinib was 19.1 months, 13.7 months, and 14.0 months, respectively (p=0.001). The superior PFS of afatinib was more remarkable in subgroups of Del19 or uncommon EGFR mutations. Overall toxicity profiles of the three drugs were comparable, though more grade 3 or 4 toxicities were detected in afatinib (7.3%) compared with gefitinib (2.6%) or erlotinib (1.8%). The common grade 3 or 4 toxicities of afatinib included diarrhea (3.0%), paronychia (2.4%), and skin rash (1.8%). Dose modification was more frequently required in patients treated with afatinib (112/165, 68%), compared with gefitinib (5/230, 2%) and erlotinib (4/72, 6%). Interestingly, however, dose reduction in the afatinib group did not impair its efficacy in terms of PFS (dose reduction vs. no reduction group, 23.5 months vs. 12.4 months).

CONCLUSION

First-line afatinib showed satisfactory efficacy data and manageable toxicity profiles.

Authors+Show Affiliations

Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29898592

Citation

Kim, Youjin, et al. "Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared With Gefitinib or Erlotinib." Cancer Research and Treatment : Official Journal of Korean Cancer Association, vol. 51, no. 2, 2019, pp. 502-509.
Kim Y, Lee SH, Ahn JS, et al. Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared with Gefitinib or Erlotinib. Cancer Res Treat. 2019;51(2):502-509.
Kim, Y., Lee, S. H., Ahn, J. S., Ahn, M. J., Park, K., & Sun, J. M. (2019). Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared with Gefitinib or Erlotinib. Cancer Research and Treatment : Official Journal of Korean Cancer Association, 51(2), pp. 502-509. doi:10.4143/crt.2018.117.
Kim Y, et al. Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared With Gefitinib or Erlotinib. Cancer Res Treat. 2019;51(2):502-509. PubMed PMID: 29898592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and Safety of Afatinib for EGFR-mutant Non-small Cell Lung Cancer, Compared with Gefitinib or Erlotinib. AU - Kim,Youjin, AU - Lee,Se-Hoon, AU - Ahn,Jin Seok, AU - Ahn,Myung-Ju, AU - Park,Keunchil, AU - Sun,Jong-Mu, Y1 - 2018/06/13/ PY - 2018/02/14/received PY - 2018/06/10/accepted PY - 2018/6/15/pubmed PY - 2019/8/8/medline PY - 2018/6/15/entrez KW - Afatinib KW - Epidermal growth factor receptor KW - First-line therapy KW - Non-small cell lung carcinoma SP - 502 EP - 509 JF - Cancer research and treatment : official journal of Korean Cancer Association JO - Cancer Res Treat VL - 51 IS - 2 N2 - PURPOSE: We tried to evaluate whether there are any specific features in treatment outcomes of firstline afatinib in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), compared with gefitinib or erlotinib. Materials and Methods: We analyzed patients treated with first-line afatinib, gefitinib, or erlotinib for advanced EGFR-mutant NSCLC at Samsung Medical Center between 2014 and 2016. RESULTS: In total, 467 patients received first-line afatinib (n=165), gefitinib (n=230), or erlotinib (n=72). Afatinib was used more often in patients with tumors harboring deletion in exon 19 (Del19), whereas the gefitinib group had more elderly, females, and never smokers. The median progression-free survival (PFS) time for afatinib, gefitinib, and erlotinib was 19.1 months, 13.7 months, and 14.0 months, respectively (p=0.001). The superior PFS of afatinib was more remarkable in subgroups of Del19 or uncommon EGFR mutations. Overall toxicity profiles of the three drugs were comparable, though more grade 3 or 4 toxicities were detected in afatinib (7.3%) compared with gefitinib (2.6%) or erlotinib (1.8%). The common grade 3 or 4 toxicities of afatinib included diarrhea (3.0%), paronychia (2.4%), and skin rash (1.8%). Dose modification was more frequently required in patients treated with afatinib (112/165, 68%), compared with gefitinib (5/230, 2%) and erlotinib (4/72, 6%). Interestingly, however, dose reduction in the afatinib group did not impair its efficacy in terms of PFS (dose reduction vs. no reduction group, 23.5 months vs. 12.4 months). CONCLUSION: First-line afatinib showed satisfactory efficacy data and manageable toxicity profiles. SN - 2005-9256 UR - https://www.unboundmedicine.com/medline/citation/29898592/Efficacy_and_Safety_of_Afatinib_for_EGFR_mutant_Non_small_Cell_Lung_Cancer_Compared_with_Gefitinib_or_Erlotinib_ L2 - https://dx.doi.org/10.4143/crt.2018.117 DB - PRIME DP - Unbound Medicine ER -