First-line afatinib for the treatment of EGFR mutation-positive non-small-cell lung cancer in the ‘real-world’ clinical setting
Journal
Therapeutic Advances in Medical Oncology
Journal Volume
11
Date Issued
2019
Author(s)
Abstract
Afatinib is an ErbB family blocker that is approved for the treatment of epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). Pivotal randomized clinical studies demonstrated that afatinib significantly prolonged progression-free survival compared with platinum-based chemotherapy (LUX-Lung 3, LUX-Lung 6), and with gefitinib (LUX-Lung 7), with manageable side effects. However, these results were derived from controlled studies conducted in selected patients and are not necessarily representative of real-world use of afatinib. To gain a broader understanding of the effectiveness and safety of first-line afatinib, we have undertaken a literature review of real-world studies that have assessed its use in a variety of patient populations. We focused on patients with uncommon EGFR mutations, brain metastases, or those of advanced age, as these patients are often excluded from clinical studies but are regularly seen in routine clinical practice. The available real-world studies suggest that afatinib has clinical activity, and is tolerable, in diverse patient populations in an everyday clinical practice setting. Moreover, consistent with LUX-Lung 7, several real-world comparative studies indicate that afatinib might confer better efficacy than first-generation EGFR tyrosine kinase inhibitors. Tolerability-guided dose adjustment, undertaken in 21–68% of patients in clinical practice, did not appear to reduce the efficacy of afatinib. Taken together, these findings provide further support for the use of afatinib as a treatment option in patients with EGFR mutation-positive NSCLC. ? The Author(s), 2019.
Subjects
afatinib; brain metastases; EGFR tyrosine kinase inhibitors; NSCLC; real-world; uncommon mutations
SDGs
Other Subjects
afatinib; carboplatin; epidermal growth factor receptor; erlotinib; gefitinib; osimertinib; acne; brain metastasis; cancer chemotherapy; clinical outcome; diarrhea; drug efficacy; drug safety; drug tolerability; gastrointestinal disease; gene mutation; human; ischemic heart disease; mucosa inflammation; non small cell lung cancer; paronychia; phase 3 clinical trial (topic); point mutation; priority journal; progression free survival; propensity score; randomized controlled trial (topic); Review; skin disease; stomatitis
Publisher
SAGE Publications Inc.
Type
review