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A. Fijiwara
Author of
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-060 - Comparative Analysis of the Efficacy of Three 1st/2nd Generation EGFR-TKIs for EGFR Mutated NSCLC in Clinical Practice (ID 6308)
14:30 - 14:30 | Author(s): A. Fijiwara
- Abstract
Background:
EGFR-TKIs show promising anti-tumor activities for EGFR mutated NSCLC, and three EGFR-TKIs, gefitinib (GEF), erlotinib (ERL) and afatinib (AFA), are available for treatment of NSCLC harboring an EGFR mutation in first-line settings in Japan. Which EGFR-TKI is optimal for first-line therapy in clinical practice, however, is not yet known.
Methods:
We reviewed all patients who were diagnosed with EGFR mutated NSCLC between January 2010 and April 2016 at two institutions in Mie, Japan. The aim of this retrospective study was to evaluate three EGFR-TKIs using time to treatment failure (TTF), overall survival (OS) and the response rate (RR) in clinical practice. TTF analysis was conducted on all patients, while OS analysis was conducted on patients in stages 3B or 4. Either chi-square statistics, or a Fisher’s exact test was used where appropriate to compare proportions among groups. Survival curves were calculated using the Kaplan-Meier method, and were compared using the log-rank test.
Results:
A total of 310 patients were diagnosed with EGFR mutated NSCLC in the three institutions. Of the 310 patients, 145 patients treated with EGFR-TKI were enrolled. The median age was 70 years old (range 37-95), 88 patients (62.9%) were female and 97 patients were never-smokers. Almost all patients (96.3%) were diagnosed with adenocarcinoma, with 52.4% diagnosed with Ex19 deletion, and 44.8% diagnosed with Ex21 L858R. 82 patients received gefitinib as the first EGFR-TKI, while 35 patients received erlotinib, and the remaining 28 patients received afatinib. The efficacy assessment demonstrated that there was no significant difference in TTF (9.4m;GEF, 9.3m;ERL, 14.1m;AFA), OS ( 24.8m;GEF, 22.7m;ERL, NR;AFA), and RR among the three EGFR-TKIs. Subgroup analysis indicated that adenocarcinoma, being a never-smoker, and the presence of a major mutation were predictive factors for a longer TTF of EGFR-TKI therapy. OS of patients with brain metastasis (BM) was significantly shorter than those without BM. (p=0.018)
Conclusion:
This study demonstrated a tendency of afatinib to be superior, however, there was no significant difference in TTF and OS among the three EGFR-TKIs as of submission. These results indicated that all EGFR-TKIs had equal clinical benefit at presence, with a potential superiority for afatinib. Further prospective investigations are warranted to evaluate the efficacy of these three EGFR-TKIs in clinical practice to confirm these results.
