Symptom and quality of life benefit of afatinib in advanced non-small-cell lung cancer patients previously treated with erlotinib or gefitinib: Results of a randomized phase iib/iii trial (lux-lung 1)
Journal
Journal of Thoracic Oncology
Journal Volume
8
Journal Issue
2
Pages
229-237
Date Issued
2013
Author(s)
Abstract
BACKGROUND: Patient-reported symptom and health-related quality of life (HRQoL) benefit of afatinib, a novel, irreversible, ErbB Family Blocker, was investigated in a double-blind, randomized, phase IIb/III trial (LUX-Lung 1). METHODS: Five hundred and eighty-five patients with lung adenocarcinoma (stage IIIb/IV), who had progressed after chemotherapy (1-2 lines) and at least 12 weeks of erlotinib or gefitinib, were randomized (2:1) to receive either afatinib plus best supportive care (BSC) or placebo plus BSC. Symptom and HRQoL benefit were measured using the lung cancer-specific European Organisation for Research and Treatment of Cancer (QLQ-C30/LC13) and EuroQol (EQ-5D) questionnaires. Non-small-cell lung cancer-related symptoms (cough, dyspnea, and pain) were prespecified using three preplanned analyses (percentage of patients improved/worsened/stable, change in scores over time, and time to deterioration of scores). RESULTS: Compared with patients on placebo, a significantly higher proportion of afatinib-treated patients showed an improvement in cough (p < 0.0001), dyspnea (p = 0.006), and pain (p < 0.0001). Afatinib also significantly improved the mean scores over time for cough (p < 0.0001), dyspnea (p = 0.0161), and pain (p = 0.0056); significantly delayed the time to deterioration for cough (p < 0.001); and showed a trend in delaying dyspnea (p = 0.170) and pain (p = 0.287). Consistent with the adverse-event profile of afatinib, a significantly (p < 0.05) higher proportion of afatinib-treated patients showed worsening of diarrhea, sore mouth, dysphagia, and appetite scores. However, compared with placebo, afatinib significantly (p < 0.05) improved QoL assessed with the EQ-5D questionnaire and global health status/QoL, physical functioning, and fatigue, which were assessed with the European Organisation for Research and Treatment of Cancer questionnaires. CONCLUSION: In the LUX-Lung 1 trial, the addition of afatinib to BSC significantly improved non-small-cell lung cancer-related symptoms (cough, dyspnea, and pain), fatigue, physical functioning, and HRQoL and significantly delayed time to deterioration of cough. Copyright ? 2012.
Subjects
Afatinib; Non-smallcell lung cancer; Phase IIb/III trial; Quality of life; Symptom benefit
SDGs
Other Subjects
afatinib; erlotinib; gefitinib; placebo; acne; adult; anorexia; arm pain; article; cancer chemotherapy; cancer growth; cancer staging; controlled study; coughing; decreased appetite; deterioration; diarrhea; double blind procedure; drug efficacy; drug eruption; dysphagia; dyspnea; human; lung adenocarcinoma; lung non small cell cancer; major clinical study; monotherapy; mouth pain; nail disease; phase 2 clinical trial; phase 3 clinical trial; priority journal; quality of life; questionnaire; randomized controlled trial; shoulder pain; stomatitis; thorax pain; Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Cough; Double-Blind Method; Dyspnea; Fatigue; Female; Follow-Up Studies; Humans; Longitudinal Studies; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Pain; Prognosis; Quality of Life; Quinazolines; Salvage Therapy
Type
journal article