13. The effectiveness of first-line afatinib 30mg daily as a starting dose in patients with advanced-stage EGFR-mutant non-small cell lung cancer
Main Article Content
Abstract
Afatinib, a tyrosine kinase inhibitor, has received approval from the Vietnamese Ministry of Health for the treatment of advanced non-small cell lung cancer. This retrospective descriptive study investigated patients diagnosed with stage IIIC/IV non-small cell lung cancer (NSCLC) according to the AJCC 8th edition, characterized by adenocarcinoma histology and harboring an EGFR mutation. These individuals underwent treatment with afatinib, initiated at a daily dosage of 30mg, at K Hospital from April 2018 to October 2023. The objectives included evaluating treatment response, progression-free survival, and adverse events. The study yielded a notable response rate of 76.9% and a high disease control rate of 94%. The overall response rate was 76.9%, and the disease control rate was 94%. The median progression-free survival time was 11.9 months. Treatment-related adverse events were documented, such as rash (29.0%), stomatitis (11.1%), paronychia (19.6%), diarrhea (39.3%), and increased liver enzymes (7.6%). Grade 3 adverse events occurred in less than 2% of the study population, with no instanceof grade 4 adverse events. The initiation of first-line afatinib treatment at a daily dose of 30 mg demonstrates positive outcomes in terms of treatment response and median progression-free survival, accompanied by a low rate of adverse effects.
Article Details
Keywords
Advanced stage, non-small cell lung cancer, EGFR mutation, afatinib, 30mg dose
References
2. Drugs.com. Gilotrif (afatinib) FDA Approval History. Boehringer Ingelheim Pharmaceuticals, Inc. Published 2013. Accessed March 7, 2024. https://www.drugs.com/history/gilotrif.html
3. Yang JCH, Wu YL, Schuler M, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol. 2015;16(2):141-151. doi:10.1016/S1470-2045(14)71173-8
4. Bộ Y tế. Bộ Y tế công bố kết quả Tổng điểu tra Dinh dưỡng năm 2019-2020. Accessed April 5, 2023. https://moh.gov.vn/tin-noi-bat/-/asset_publisher/3Yst7YhbkA5j/content/bo-y-te-cong-bo-ket-qua-tong-ieu-tra-dinh-duong-nam-2019-2020
5. Yang JCH, Sequist LV, Zhou C, et al. Effect of dose adjustment on the safety and efficacy of afatinib for EGFR mutation-positive lung adenocarcinoma: post hoc analyses of the randomized LUX-Lung 3 and 6 trials. Ann Oncol. 2016;27(11):2103-2110. doi:10.1093/annonc/mdw322
6. Halmos B, Tan EH, Soo RA, et al. Impact of afatinib dose modification on safety and effectiveness in patients with EGFR mutation-positive advanced NSCLC: Results from a global real-world study (RealGiDo). Lung Cancer. 2019;127:103-111. doi:10.1016/j.lungcan.2018.10.028
7. Schuler M, Paz-Ares L, Sequist LV, et al. First-line afatinib for advanced EGFRm+ NSCLC: Analysis of long-term responders in the LUX-Lung 3, 6, and 7 trials. Lung Cancer. 2019;133:10-19. doi:10.1016/j.lungcan.2019.04.006
8. European Medicines Agency. Giotrif: EPAR-product information. Published 2013. Accessed March 20, 2024. https://www.ema.europa.eu/en/documents/product-information/giotrif-epar-product-information_en.pdf
9. ECOG-ACRIN Cancer Research Group. ECOG Performance Status Scale. Accessed March 13, 2023. https://ecog-acrin.org/resources/ecog-performance-status/
10. Schwartz LH, Seymour L, Litière S, et al. RECIST 1.1 - Standardisation and disease-specific adaptations: Perspectives from the RECIST Working Group. Eur J Cancer Oxf Engl 1990. 2016;62:138-145. doi:10.1016/j.ejca.2016.03.082
11. Brindel A, Althakfi W, Barritault M, et al. Uncommon EGFR mutations in lung adenocarcinoma: features and response to tyrosine kinase inhibitors. J Thorac Dis. 2020;12(9). doi:10.21037/jtd-19-3790
12. Yang JCH, Sequist LV, Geater SL, et al. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol. 2015;16(7):830-838. doi:10.1016/S1470-2045(15)00026-1