Real-world analysis of afatinib as a first-line treatment for patients with advanced stage non-small-cell lung cancer with uncommon EGFR mutations: a multicenter study in Vietnam.

Autor:	Pham VL; 108 Military Central Hospital, Hanoi, Hai Ba Trung, Vietnam., Le TA; Oncology Center, Cho Ray Hospital, Ho Chi Minh City 72760, Vietnam., Pham CP; Bach Mai Hospital, Hanoi, Vietnam., Hoa Nguyen TT; Vietnam National Cancer Hospital, Hanoi, Vietnam., Do AT; Vietnam National Cancer Hospital, Hanoi, Vietnam., Nguyen TK; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Nguyen MH; 108 Military Central Hospital, Hanoi, Hai Ba Trung, Vietnam., Thu Hoang TA; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Hao Vuong DT; Cho Ray Hospital, Ho Chi Minh, Vietnam., Tam Nguyen DN; Thong Nhat Hospital, Ho Chi Minh, Vietnam., Khiem Dang V; National Lung Hospital, Hanoi, Vietnam., Nguyen TO; National Lung Hospital, Hanoi, Vietnam., Trang Vo TH; Bach Mai Hospital, Hanoi, Vietnam., Do HK; Vietnam National Cancer Hospital, Hanoi, Vietnam., Vu HT; Vietnam National Cancer Hospital, Hanoi, Vietnam., Nguyen TTH; Vietnam National Cancer Hospital, Hanoi, Vietnam., Pham VT; Department of Oncology, Hanoi Medical University, Hanoi, Vietnam., Trinh LH; Department of Oncology, Hanoi Medical University, Hanoi, Vietnam., Dung Nguyen K; Vietnam National Cancer Hospital, Hanoi, Vietnam., Nguyen HG; Hanoi Oncology Hospital, Hanoi, Vietnam., Truong CM; Vietnam National Cancer Hospital, Hanoi, Vietnam., Chau Pham TM; Ho Chi Minh City Oncology Hospital, Ho Chi Minh, Vietnam., Nguyen TBP; Vietnam National Cancer Hospital, Hanoi, Vietnam.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in medical oncology [Ther Adv Med Oncol] 2024 May 09; Vol. 16, pp. 17588359241242972. Date of Electronic Publication: 2024 May 09 (Print Publication: 2024).
DOI:	10.1177/17588359241242972
Abstrakt:	Background: Afatinib is indicated for advanced-stage non-small-cell lung cancer (NSCLC) with Epidermal Growth Factor Receptor (EGFR) and uncommon mutations. However, real-world studies on this topic are limited. This study aimed to evaluate afatinib as first-line therapy for locally advanced and metastatic NSCLC with uncommon EGFR mutations. Patients and Methods: A retrospective study included 92 patients with advanced NSCLC with uncommon and compound EGFR mutations, treated with afatinib as first-line therapy. Patients were followed up and evaluated every 3 months or when symptoms of progressive disease arose. The endpoints were objective response rate (ORR), time-to-treatment failure (TTF), and adverse events. Results: The G719X EGFR mutation had the highest occurrence rate (53.3% for both monotherapy and the compound). By contrast, the compound mutation G719X-S768I was observed at a rate of 22.8%. The ORR was 75%, with 15.2% of patients achieving complete response. The overall median TTF was 13.8 months. Patients with the G719X EGFR mutation (single and compound) had a median TTF of 19.3 months, longer than that of patients with other mutations, who had a median TTF of 11.2 months. Patients with compound EGFR mutations (G719X and S768I) demonstrated a median TTF of 23.2 months compared to that of 12.3 months for other mutations. Tolerated doses of 20 or 30 mg achieved a longer median TTF of 17.1 months compared to 11.2 months with 40 mg. Median TTF differed between patients with and without brain metastasis, at 11.2 and 16.9 months, respectively. Rash (55.4%) and diarrhea (53.3%) were the most common adverse events, primarily grades 1 and 2. Other side effects occurred at a low rate. Conclusion: Afatinib is effective for locally advanced metastatic NSCLC with uncommon EGFR mutations. Patients with G719X, compound G719X-S768I mutations, and tolerated doses of 20 or 30 mg had a longer median TTF than those with other mutations. Competing Interests: The authors declare that there is no conflict of interest. (© The Author(s), 2024.)
Databáze:	MEDLINE
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