Real-world assessment of afatinib for patients with EGFR -positive non-small cell lung cancer
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SHORT REPORT
Real-world assessment of afatinib for patients with EGFR-positive non-small cell lung cancer Satoshi Igawa 1 & Taihei Ono 1 & Masashi Kasajima 1 & Seiichiro Kusuhara 1 & Sakiko Otani 1 & Tomoya Fukui 1 & Masanori Yokoba 2 & Masaru Kubota 2 & Masato Katagiri 2 & Hisashi Mitsufuji 3 & Jiichiro Sasaki 4 & Katsuhiko Naoki 1 Received: 23 April 2020 / Accepted: 7 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Summary Introduction Afatinib is used to treat patients with advanced non-small cell lung cancer (NSCLC) harboring common EGFR mutations; however, the clinicopathological factors that predict this drug’s effectiveness in real-world settings remain unclear. We therefore evaluated the effectiveness of afatinib in such patients and assessed potential prognostic factors. Methods We retrospectively investigated patients with NSCLC who received first-line afatinib between July 2014 and August 2018. Variables (including sex, age, performance status, neutrophil-to-lymphocyte ratio, EGFR genotype, smoking status, clinical stage prior to treatment [stage IV vs.. postoperative recurrence], presence or absence of brain metastases, body surface area, any afatinib dose reductions, and afatinib starting dose [40 vs.. 20 or 30 mg]) were subjected to a Cox proportional hazards regression model to estimate progression-free survival (PFS). Results Forty-eight patients with a median age of 67 years were included; the objective response rate was 62.5% (30 patients). The median PFS was 14.1 months; the PFS periods were 11.8 and 15.9 months for patients receiving 40 mg versus 20–30 mg of afatinib (P = 0.41), respectively, and were 14.5 and 13.8 months for patients who required afatinib dose reduction and those who did not, respectively (P = 0.80). The PFS tended to be longer in patients without brain metastases (albeit not significantly). Ultimately, no significant predictive values for PFS were identified. Conclusions Afatinib is effective for patients with NSCLC harboring common EGFR mutations irrespective of their clinicopathological backgrounds. A direct comparison of afatinib and osimertinib in treatment-naïve patients is warranted to determine the optimal standard of care. Keywords Non-small cell lung cancer . Real-world . Afatinib . Predictive factor
Introduction Lung cancer is among the major causes of cancer-related mortality worldwide [1], and non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung malignancies [2].
* Satoshi Igawa [email protected] 1
Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Kanagawa 252-0374 Sagamihara-City, Japan
2
School of Allied Health Sciences, Kitasato University, Kanagawa 252-0373 Sagamihara-City, Japan
3
Kitasato University School of Nursing, Kanagawa Sagamihara-City, Japan
4
Kitasato University School of Medicine, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Kanagawa Sagamihara-City, Japan
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