Comparing the effects of afatinib with gefitinib or Erlotinib in patients with advanced-stage lung adenocarcinoma harboring non-classical epidermal growth factor receptor mutations

Shen, Yi Cheng; Tseng, Guan Chin; Tu, Chih Yeh; Chen, Wei Chun; Liao, Wei; Chen, Wei Cheng; Li, Chia-Hsiang; Chen, Hung Jen; Hsia, Te Chun

doi:10.1016/j.lungcan.2017.06.007

Cited by 85 publications

(89 citation statements)

References 32 publications

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“…The results of the study showed that the Progression of Free Survival (PFS) afatinib was better than ge itinib; this can be seen in Figures 1 and 2. This is consistent with the LUX-Lung 7 phase 2B clinical trial research and a meta-analysis has been found that afatinib has a longer PFS than ge itinib and is signi icantly (p <0.005) superior to ge itinib (11 months vs. 10.9 months) (Liang et al, 2014) (Park et al, 2016) (Krawczyk et al, 2017;Shen et al, 2017). Afatinib can irreversibly block ErbB more effectively than reversible inhibition of EGFR on ge itinib in the treatment of NSCLC with EGFR mutations.…”

Section: Resultssupporting

confidence: 87%

Effectiveness of Afatinib and Gefitinib in Non-Small Cell Lung Cancer (NSCLC) Epidermal Growth Factor Receptor (EGFR) Mutations in Indonesia: Observational Studies with Retrospectives

Sari

Andayani

Endarti

et al. 2019

ijrps

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Effectiveness data can describe the results or performance of an intervention (treatment) in daily clinical practice and also provide recommendations to policymakers regarding the need or not of health technology to be implemented into the health care system. Research related to the effectiveness of afatinib and gefitinib is still minimal, especially in Indonesia. This study aims to provide an overview of the effectiveness of afatinib and gefitinib in daily clinical practice (the real world) as first-line therapy. This research is an observational study with a retrospective approach that observes the medical records of NSCLC patients who have EGFR mutations in Dr. Sardjito General Hospital Yogyakarta and Dr. Kariadi General Hospital Semarang, Java Island, Indonesia in the period January 2016 - March 2019. The effectiveness seen is the Progress Free Survival and Overall Survival based on the patient's medical records and analyzed using the Kaplan Meier test to see survival. There were 113 patients identified, 27 patients using afatinib and 86 patients using gefitinib. Afatinib had significantly superior progression-free survival (448 days or 14.7 months; 95% CI = 12-17.4 months; p = 0.002) compared to gefitinib (344 days or 11.3 months; 95% CI = 8, 4-14.3 months), however, overall survival of afatinib is no better than gefitinib (472 days or 15.5 months; 95% CI = 13.8-17.2 months vs 653 days or 21.4 months; 95% CI = 18-24.8 months) with a value of p = 0.302. Afatinib has superior progression-free survival compared to gefitinib, but not overall survival as first-line therapy in NSCLC patients with EGFR mutations.

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Section: Resultssupporting

confidence: 87%

Effectiveness of Afatinib and Gefitinib in Non-Small Cell Lung Cancer (NSCLC) Epidermal Growth Factor Receptor (EGFR) Mutations in Indonesia: Observational Studies with Retrospectives

Sari

Andayani

Endarti

et al. 2019

ijrps

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“…According to previous studies, erlotinib has benefits over gefitinib in patients with EGFR-mutated patients with leptomeningeal NSCLC metastases that progressed during gefitinib treatment but responded to erlotinib (28,29). Additionally, recent studies demonstrated that erlotinib-treated patients have better PFS and OS time compared with the gefitinib-treated group (29,30). At present, this is no definite conclusion of TKI type choice in 1st-line treatment of EGFR-mutant NSCLC patients with brain metastases (31).…”

Section: St-line Cht + 2nd-line Tki N=50 1st-line Tki + 2nd-line Chmentioning

confidence: 99%

The effect of TKI therapy and chemotherapy treatment delivery sequence on total progression‑free survival in patients with advanced EGFR‑mutated NSCLC

Han

Zhou

et al. 2020

Oncol Lett

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The present study aimed to evaluate the total progression-free survival (PFS) time of the 1st-line chemotherapy (CHT)/2nd-line tyrosine kinase inhibitor (TKI) and 1st-line TKI/2nd-line CHT therapeutic regimens. Data from patients with non-small-cell lung cancer (NSCLC) harboring sensitizing epidermal growth factor receptor (EGFR) mutations, who had received both TKI and platinum CHT were retrieved from the Shandong Cancer Hospital (Jinan, China) database. A total of 89 patients were included, 50 of whom were treated with the 1st-line CHT/2nd-line TKI regimen and the remaining 39 patients underwent a 1st-line TKI/2nd-line CHT regimen. The differences in total PFS time between the two regimens were analyzed. The median total PFS time was 14.28 months with the 1st-line CHT/2nd-line TKI regimen and 17.77 months with the 1st-line TKI/2nd-line CHT regimen (adjusted hazard ratio, 0.96; 95% confidence interval (CI), 0.56-1.66; P=0.886). A significant difference in PFS time was revealed between the two strategies when comparing only the 1st-line or 2nd-line treatments (all P<0.001). The objective response rate (RR) was 52.0% for those treated with 1st-line CHT/2nd-line TKI and 38.5% for the reverse regimen. After adjusting for associated factors, the odds ratio for the RR was 2.77 (95% CI: 0.77-9.90; P=0.117). The current results revealed that there was no significant difference between the total PFS time of patients with NSCLC undergoing the 1st-line CHT/2nd-line TKI regimen compared with patients with NSCLC undergoing the 1st-line TKI/2nd-line CHT regimen.

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“…12,13 Despite being excluded from most clinical trials, 7% to 23% of NSCLC tumors harbor uncommon EGFR mutations. [14][15][16][17][18][19][20][21] These mutations represent a highly heterogeneous group with almost 600 variants identified. 22 The most prevalent categories include exon 20 insertions (w6% of all EGFR mutations), G719X (w3%), L861Q (w1%), S768I (w1%), and exon 19 insertions (0.6%).…”

Section: Introductionmentioning

confidence: 99%

Afatinib for the Treatment of NSCLC Harboring Uncommon EGFR Mutations: A Database of 693 Cases

Yang

Schüler

Popat

et al. 2020

Journal of Thoracic Oncology

185

190

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Introduction: Limited clinical data are available regarding the efficacy of EGFR tyrosine kinase inhibitors (EGFR TKIs) in patients with NSCLC harboring uncommon EGFR mutations. This pooled analysis assessed the activity of afatinib in 693 patients with tumors harboring uncommon EGFR mutations treated in randomized clinical trials, compassionate-use and expanded-access programs, phase IIIb trials, noninterventional trials, and case series or studies. Methods: Patients had uncommon EGFR mutations, which were categorized as follows: (1) T790M; (2) exon 20 insertions; (3) "major" uncommon mutations (G719X, L861Q, and S768I, with or without any other mutation except T790M or an exon 20 insertion); (4) compound mutations; and (5) other uncommon mutations. Key end points were overall response rate (ORR), duration of response, and time to treatment failure (TTF). Results: In EGFR TKI-naive patients (n ¼ 315), afatinib demonstrated activity against major uncommon mutations (median TTF ¼ 10.8 mo; 95% confidence interval [CI]: 8.1-16.6; ORR ¼ 60.0%), compound mutations (median TTF ¼ 14.7 mo; 95% CI: 6.8-18.5; ORR ¼ 77.1%), other uncommon mutations (median TTF ¼ 4.5 mo; 95% CI: 2.9-*Corresponding author.

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Comparing the effects of afatinib with gefitinib or Erlotinib in patients with advanced-stage lung adenocarcinoma harboring non-classical epidermal growth factor receptor mutations

Cited by 85 publications

References 32 publications

Effectiveness of Afatinib and Gefitinib in Non-Small Cell Lung Cancer (NSCLC) Epidermal Growth Factor Receptor (EGFR) Mutations in Indonesia: Observational Studies with Retrospectives

Effectiveness of Afatinib and Gefitinib in Non-Small Cell Lung Cancer (NSCLC) Epidermal Growth Factor Receptor (EGFR) Mutations in Indonesia: Observational Studies with Retrospectives

The effect of TKI therapy and chemotherapy treatment delivery sequence on total progression‑free survival in patients with advanced EGFR‑mutated NSCLC

Afatinib for the Treatment of NSCLC Harboring Uncommon EGFR Mutations: A Database of 693 Cases

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