ISSN: 1859 - 2872
Afatinib as a first-line treatment in patients with advanced stage lung adenocarcinoma with common EGFR mutations
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Abstract
Background: Afatinib is currently indicated as first-line treatment for patients with advanced non-small cell lung cancer (NSCLC), including advanced adenocarcinoma with common and uncommon EGFR mutations. The objective of the study was to evaluate the results of first-line treatment by Afatinib in patients with advanced stage lung adenocarcinoma with common EGFR mutations using. Subject and method: A retrospective combines prospective study, longitudinal follow-up of 54 patients with advanced stage lung adenocarcinoma carrying EGFR exon 19 deletion or L858R point mutation, treated with Afatinib as first-line treatment. Patients were followed and evaluated every 3 months or when there were symptoms of disease progression. The primary endpoints were progression-free survival (PFS), objective response rate (ORR), and secondary endpoints were disease control rate (DCR), and overall survival (OS). Result: The mean of age was 61.56 years, most of patients were male, had no history of smoking, and carried the EGFR exon 19 deletion mutation. The ORR was 72.2%, and the DCR was 100%. The overall median PFS was 14 months, and the median OS was 28 months. The median PFS of patients with exon 19 deletion and L858R mutations were both 14 months. The median OS of patients with exon 19 deletion was 28 months, while the median OS of the L858R group was not reach, p=0.67. Median PFS and OS in patients without brain metastasis tended to be longer than those with brain metastasis (15 months vs. 11 months, p=0.74 and 28 months vs. 17 months, p=0.51 respectively). The median OS for patients with a maintenance dose < 40 mg was 28 months, a trend longer than the median OS for patients with a maintenance dose of 40 mg (18 months), p=0.68. Conclusion: Afatinib is an EGFR-TKI that is effective in the first-line treatment of patients with advanced stage lung adenocarcinoma carrying common EGFR mutations in terms of both response rate and survival.
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References
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