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P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.

Background: Published reports of first-line afatinib treatment efficacy, side-effects and resistance mechanism in the real-world setting are lacking. Method: A retrospective observational study of patients with EGFR mutant advanced non-small cell lung cancer (NSCLC) receiving first-line afatini...

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Main Authors: Chai, Chee Shee, Liam, Chong Kin, Ho, G., A, Binti Alip, Pang, Y.
Format: E-Article
Language:English
Published: Elsevier 2018
Subjects:
R Medicine (General)
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Online Access:http://ir.unimas.my/id/eprint/22819/1/Real-World%20Experience%20of%20First-Line%20Afatinib.pdf
http://ir.unimas.my/id/eprint/22819/
https://www.jto.org/article/S1556-0864(18)32855-7/fulltext
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spelling my.unimas.ir.228192019-07-09T06:51:06Z http://ir.unimas.my/id/eprint/22819/ P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer. Chai, Chee Shee Liam, Chong Kin Ho, G. A, Binti Alip Pang, Y. R Medicine (General) RC0254 Neoplasms. Tumors. Oncology (including Cancer) Background: Published reports of first-line afatinib treatment efficacy, side-effects and resistance mechanism in the real-world setting are lacking. Method: A retrospective observational study of patients with EGFR mutant advanced non-small cell lung cancer (NSCLC) receiving first-line afatinib in University Malaya Medical Center from 1st December 2014 to 30th April 2018. Result: Twenty-two of 33 patients on first-line afatinib were eligible for analysis. The patients’ demographic and clinical characteristics are as shown in Table 1. The mPFS was 14.3 months, overall response rate was 86.3% (19/22) and disease control rate was 95.5% (21/22). The median time-to-treatment failure was 16.2 months. The median overall survival has not been reached but 12-month survival rate was 81.8% (18/22). A patient with exon 18 G719X and exon 20 S768I mutation had received treatment for 23.3 months without disease progression (PD). The PFS of a patient with exon 20 insertion was 9 months and of another patient with exon 18 G719X and exon 20 T790M mutations was 4.4 months. Of patients with brain metastases, the PFS of 2 patients treated with stereotactic radiosurgery (SRS) was 15.9 months and 9 months, respectively while that of a patient who had whole brain radiotherapy (WBRT) and a patient who underwent debulking surgery only was 16.5 months and 2.6 months, respectively. The incidence of side-effects was rash 90.1% (20/22), stomatitis 63.3% (14/22), paronychia 72.7% (16/22), and diarrhea 77.3% (17/22). One (4.5%) patient each had grade 3 diarrhea and cutaneous lesions. Of 17 patients with PD, 2 (11.8%) had PD in the brain. T790M mutation was detected in 62.2% (8/13) patients who underwent repeat biopsy. Conclusion: Afatinib is an effective treatment of EGFR-mutant advanced NSCLC. When combined with SRS or WBRT, afatinib conferred good PFS in patients with symptomatic brain metastases. Severe side effects are uncommon and T790M mutation was the commonest resistance mechanism. Elsevier 2018-10 E-Article PeerReviewed text en http://ir.unimas.my/id/eprint/22819/1/Real-World%20Experience%20of%20First-Line%20Afatinib.pdf Chai, Chee Shee and Liam, Chong Kin and Ho, G. and A, Binti Alip and Pang, Y. (2018) P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer. Journal of Thoracic Oncology, 13 (10). S998-999. ISSN 1556-0864 https://www.jto.org/article/S1556-0864(18)32855-7/fulltext DOI: https://doi.org/10.1016/j.jtho.2018.08.1897
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
language English
topic R Medicine (General)
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
spellingShingle R Medicine (General)
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Chai, Chee Shee
Liam, Chong Kin
Ho, G.
A, Binti Alip
Pang, Y.
P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
description Background: Published reports of first-line afatinib treatment efficacy, side-effects and resistance mechanism in the real-world setting are lacking. Method: A retrospective observational study of patients with EGFR mutant advanced non-small cell lung cancer (NSCLC) receiving first-line afatinib in University Malaya Medical Center from 1st December 2014 to 30th April 2018. Result: Twenty-two of 33 patients on first-line afatinib were eligible for analysis. The patients’ demographic and clinical characteristics are as shown in Table 1. The mPFS was 14.3 months, overall response rate was 86.3% (19/22) and disease control rate was 95.5% (21/22). The median time-to-treatment failure was 16.2 months. The median overall survival has not been reached but 12-month survival rate was 81.8% (18/22). A patient with exon 18 G719X and exon 20 S768I mutation had received treatment for 23.3 months without disease progression (PD). The PFS of a patient with exon 20 insertion was 9 months and of another patient with exon 18 G719X and exon 20 T790M mutations was 4.4 months. Of patients with brain metastases, the PFS of 2 patients treated with stereotactic radiosurgery (SRS) was 15.9 months and 9 months, respectively while that of a patient who had whole brain radiotherapy (WBRT) and a patient who underwent debulking surgery only was 16.5 months and 2.6 months, respectively. The incidence of side-effects was rash 90.1% (20/22), stomatitis 63.3% (14/22), paronychia 72.7% (16/22), and diarrhea 77.3% (17/22). One (4.5%) patient each had grade 3 diarrhea and cutaneous lesions. Of 17 patients with PD, 2 (11.8%) had PD in the brain. T790M mutation was detected in 62.2% (8/13) patients who underwent repeat biopsy. Conclusion: Afatinib is an effective treatment of EGFR-mutant advanced NSCLC. When combined with SRS or WBRT, afatinib conferred good PFS in patients with symptomatic brain metastases. Severe side effects are uncommon and T790M mutation was the commonest resistance mechanism.
format E-Article
author Chai, Chee Shee
Liam, Chong Kin
Ho, G.
A, Binti Alip
Pang, Y.
author_facet Chai, Chee Shee
Liam, Chong Kin
Ho, G.
A, Binti Alip
Pang, Y.
author_sort Chai, Chee Shee
title P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
title_short P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
title_full P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
title_fullStr P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
title_full_unstemmed P3. 15-21 Real-World Experience of First-Line Afatinib Treatment in Patients with EGFR Mutant Advanced Non-Small Cell Lung Cancer.
title_sort p3. 15-21 real-world experience of first-line afatinib treatment in patients with egfr mutant advanced non-small cell lung cancer.
publisher Elsevier
publishDate 2018
url http://ir.unimas.my/id/eprint/22819/1/Real-World%20Experience%20of%20First-Line%20Afatinib.pdf
http://ir.unimas.my/id/eprint/22819/
https://www.jto.org/article/S1556-0864(18)32855-7/fulltext
_version_ 1644513879616651264
score 13.211869

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