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T. Koizumi
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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-067 - A Single-Institution Experience of Afatinib in Patients with EGFR-Mutated Advanced Non-Small Cell Lung Cancer (ID 5148)
14:30 - 14:30 | Author(s): T. Koizumi
- Abstract
Background:
Afatinib, an irreversible ErbB family blocker, inhibits EGFR, HER2, and HER4. LUX-Lung 1 and 4 showed that afatinib was effective for patients with EGFR-mutated non-small cell lung cancer (NSCLC) who experienced progression after chemotherapy and gefitinib/erlotinib therapy. LUX-Lung 3 and 6 showed that afatinib had a significantly better response rate and prolonged progression free survival (PFS) compared with pemetrexed plus cisplatin or gemcitabine plus cisplatin in a first-line setting. However, those trials recruited only patients who met inclusion criteria. Thus, the relevance of the outcomes needs to be examined in a clinical setting. Moreover, diarrhea and skin rash are frequently observed in patients receiving afatinib. Establishing optimal management of adverse events is essential to improve clinical outcomes and quality of life in patients receiving afatinib.
Methods:
We retrospectively reviewed chart records of 15 EGFR-mutated NSCLC patients who had received afatinib from July 2014 to August 2015 at our institution.
Results:
Median age was 68 years (range, 53–72 years). Fourteen patients had adenocarcinoma. Nine and 4 patients had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 and 1, respectively. Three and 6 patients were treated as first- and third-line therapies, respectively. Thirteen patients had exon 19 deletion. One patient harbored both an L858R mutation in exon 21 and a de novo T790M mutation in exon 20. PFS of the 3 patients who were treated with afatinib as first-line therapy was 0.9, 6.8, and 16.4 months. Median PFS of 12 patients who had previous EGFR-TKI therapy was 4.0 months (95% confidential interval 2.1–5.9 months). The de novo T790M NSCLC patient experienced disease progression at 1.3 months. The response rate of pretreated patients was 16%. Fourteen patients were treated with afatinib 40 mg/day. One patient began afatinib 20 mg/day because of ECOG PS 2. Dose reduction was required in 8 (53%) patients. Grade 3 or 4 adverse events occurred in 3 (20%) patients. One patient had grade 3 paronychia and another patient had grade 3 diarrhea. Both patients could continue afatinib with dose reduction. Five patients had reduction of afatinib to 30 mg/day and 2 patients required reduction by 10-mg decrements down to 20 mg/day.
Conclusion:
Clinical outcomes in terms of PFS and objective response rate of afatinib in our EGFR-mutated NSCLC patients with prior therapy were comparable to LUX-Lung 1 and 4. Adverse events were tolerable and manageable with careful dose reduction.
