Sequencing of therapy following first-line afatinib in patients with EGFR mutation-positive non-small cell lung cancer

Autor: Kenneth J. O'Byrne, Jaafar Bennouna, Vera Hirsh, Kazuhiko Nakagawa, Eng Huat Tan, Yi-Long Wu, Tony Mok, Shun Lu, Li Zhang, James Chih-Hsin Yang, Martin Schuler, Toyoaki Hida, Hiroshi Tanaka, Terufumi Kato, Keunchil Park, Denis Moro Sibilot, Michael Boyer, Nobuyuki Yamamoto, Angela Märten, Caicun Zhou, W. Tang, Luis Paz-Ares
Rok vydání: 2019
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Oncology
Adult
Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Afatinib
medicine.medical_treatment
Medizin
Platinum Compounds
03 medical and health sciences
0302 clinical medicine
Internal medicine
Carcinoma
Non-Small-Cell Lung
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Osimertinib
Epidermal growth factor receptor
Lung cancer
Protein Kinase Inhibitors
Aged
Neoplasm Staging
Retrospective Studies
Aged
80 and over
Chemotherapy
Acrylamides
Aniline Compounds
biology
business.industry
Middle Aged
medicine.disease
Survival Analysis
Discontinuation
ErbB Receptors
030104 developmental biology
Treatment Outcome
030220 oncology & carcinogenesis
Mutation
biology.protein
Female
Non small cell
business
Tyrosine kinase
medicine.drug
Zdroj: Lung cancer (Amsterdam, Netherlands). 132
ISSN: 1872-8332
Popis: Objectives With the availability of several epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), sequential therapy could potentially render EGFR mutation-positive non-small cell lung cancer a chronic disease in some patients. In this retrospective analysis of EGFR mutation-positive (Del19/L858R) patients receiving first-line afatinib in LUX-Lung 3, 6, and 7, we assessed uptake of, and outcomes following, subsequent therapies including the third-generation EGFR TKI, osimertinib. Methods Post-progression therapy data were prospectively collected during follow-up. Molecular testing of tumours at progression/discontinuation of afatinib was not mandatory. Duration of subsequent therapies, and survival following osimertinib, were calculated with Kaplan–Meier estimates. Results Among 553 patients who discontinued first-line afatinib, second-, third- and fourth-line therapy was administered in 394 (71%), 265 (48%), and 156 (28%) patients. The most common post-progression therapy was platinum-based chemotherapy (46%). Thirty-seven patients received subsequent osimertinib, 10 as second-line treatment. Median progression-free survival on afatinib in these 37 patients was 21.9 months. Median duration of osimertinib therapy was 20.2 months; median overall survival was not reached after a median follow-up of 4.7 years. Conclusions Most patients treated with first-line afatinib received subsequent therapy. Although limited by sample size, enrichment, and a retrospective nature, data from patients who received sequential afatinib and osimertinib are encouraging, warranting further investigation.
Databáze: OpenAIRE
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