A real-world cohort study of first-line afatinib in patients with EGFR-mutant advanced non-small cell lung cancer in Vietnam.

Autor: Pham CP; Bach Mai Hospital, Hanoi, Vietnam., Nguyen TTH; Vietnam National Cancer Hospital, Hanoi, Vietnam. bshoabvk@gmail.com., Do AT; Vietnam National Cancer Hospital, Hanoi, Vietnam. doanhtu.bvk@gmail.com., Nguyen TK; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Hoang TAT; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Le TA; Cho Ray Hospital, Ho Chi Minh, Vietnam., Vuong DTH; Cho Ray Hospital, Ho Chi Minh, Vietnam., Nguyen DNT; Thong Nhat Hospital, Ho Chi Minh, Ghana., Dang VK; National Lung Hospital, Hanoi, Vietnam., Nguyen TO; National Lung Hospital, Hanoi, Vietnam., Pham VL; 108 Military Central Hospital, Hanoi, Vietnam., Nguyen MH; 108 Military Central Hospital, Hanoi, Vietnam., Vo THT; Bach Mai Hospital, Hanoi, Vietnam., Do HK; Vietnam National Cancer Hospital, Hanoi, Vietnam., Vu HT; Vietnam National Cancer Hospital, Hanoi, Vietnam.; Hanoi Medical University, Hanoi, Vietnam., Nguyen TTH; Vietnam National Cancer Hospital, Hanoi, Vietnam., Pham VT; Bach Mai Hospital, Hanoi, Vietnam.; Hanoi Medical University, Hanoi, Vietnam., Trinh LH; Hanoi Medical University, Hanoi, Vietnam., Nguyen KD; Vietnam National Cancer Hospital, Hanoi, Vietnam., Nguyen HG; Hanoi Oncology Hospital, Hanoi, Vietnam., Truong CM; Vietnam National Cancer Hospital, Hanoi, Vietnam., Pham TMC; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Nguyen TBP; Vietnam National Cancer Hospital, Hanoi, Vietnam.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2024 Feb 05; Vol. 24 (1), pp. 176. Date of Electronic Publication: 2024 Feb 05.
DOI: 10.1186/s12885-024-11891-w
Abstrakt: Background: This study aimed to evaluate the efficacy and side effects of first-line afatinib treatment in a real-world setting in Vietnam.
Methods: This retrospective study was conducted across nine hospitals in Vietnam. Advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients who received afatinib as first-line therapy between April 2018 and June 2022 were included, and patient medical records were reviewed. Key outcomes were overall response rate (ORR), time-to-treatment failure (TTF), and tolerability.
Results: A total of 343 patients on first-line afatinib were eligible for the study. EGFR exon 19 deletion (Del19) alone was detected in 46.9% of patients, L858R mutation alone in 26.3%, and other uncommon EGFR mutations, including compound mutations, in 26.8%. Patients with brain metastases at baseline were 25.4%. Patients who received 40 mg, 30 mg, and 20 mg as starting doses of afatinib were 58.6%, 39.9%, and 1.5%, respectively. The ORR was 78.1% in the overall population, 82.6% in the Del19 mutation subgroup, 73.3% in the L858R mutation subgroup, and 75.0% in the uncommon mutation subgroup (p > 0.05). The univariate and multivariate analyses indicate that the ORR increased when the starting dose was 40 mg compared to starting doses below 40 mg (83.9% vs. 74.3%, p = 0.034). The median TTF (mTTF) was 16.7 months (CI 95%: 14.8-18.5) in all patients, with a median follow-up time of 26.2 months. The mTTF was longer in patients in the common EGFR mutation subgroup (Del19/L858R) than in those in the uncommon mutation subgroup (17.5 vs. 13.8 months, p = 0.045) and in those without versus with brain metastases at baseline (17.5 vs. 15.1 months, p = 0.049). There were no significant differences in the mTTF between subgroups based on the starting dose of 40 mg and < 40 mg (16.7 vs. 16.9 months, p > 0.05). The most common treatment-related adverse events (any grade/grade ≥ 3) were diarrhea (55.4%/3.5%), rash (51.9%/3.2%), paronychia (35.3%/5.0%), and stomatitis (22.2%/1.2%).
Conclusions: Afatinib demonstrated clinical effectiveness and good tolerability in Vietnamese EGFR-mutant NSCLC patients. In our real-world setting, administering a starting dose below 40 mg might result in a reduction in ORR; however, it might not have a significant impact on TTF.
(© 2024. The Author(s).)
Databáze: MEDLINE
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