Sequencing of therapy following first-line afatinib in patients with EGFR mutation-positive non-small cell lung cancer
Journal
Lung Cancer
Journal Volume
132
Pages
126-131
Date Issued
2019
Author(s)
Park K
Bennouna J
Boyer M
Hida T
Hirsh V
Kato T
Lu S
Mok T
Nakagawa K
O'Byrne K
Paz-Ares L
Schuler M
Sibilot D.M
Tan E.-H
Tanaka H
Wu Y.-L
Zhang L
Zhou C
Märten A
Tang W
Yamamoto N.
Abstract
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. ? 2019 The Authors
Subjects
Afatinib; Non-small cell lung cancer; Osimertinib
SDGs
Other Subjects
afatinib; cisplatin; epidermal growth factor receptor; gemcitabine; osimertinib; pemetrexed; acrylamide derivative; afatinib; aniline derivative; antineoplastic agent; EGFR protein, human; epidermal growth factor receptor; osimertinib; platinum derivative; protein kinase inhibitor; adult; aged; Article; cancer chemotherapy; cancer patient; cancer survival; cancer therapy; controlled study; drug withdrawal; EGFR gene; female; follow up; gene mutation; human; major clinical study; male; multiple cycle treatment; non small cell lung cancer; overall survival; priority journal; progression free survival; prospective study; retrospective study; treatment duration; cancer staging; clinical trial; genetics; lung tumor; middle aged; mortality; mutation; non small cell lung cancer; phase 2 clinical trial; phase 3 clinical trial; randomized controlled trial; survival analysis; treatment outcome; very elderly; Acrylamides; Adult; Afatinib; Aged; Aged, 80 and over; Aniline Compounds; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; ErbB Receptors; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Neoplasm Staging; Platinum Compounds; Protein Kinase Inhibitors; Retrospective Studies; Survival Analysis; Treatment Outcome
Publisher
Elsevier Ireland Ltd
Type
journal article