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Sequential treatment of afatinib and osimertinib or other regimens in patients with advanced non-small-cell lung cancer harboring EGFR mutations: Results from a real-world study in South Korea

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Abstract
Objectives The optimal sequence for the administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for treating non-small cell lung cancer (NSCLC) is still unclear. This study aimed to evaluate the efficacy of sequential afatinib and osimertinib treatment in patients with NSCLC harboring EGFR mutations. Materials and methods Electronic records of patients with EGFR-mutated NSCLC, who were administered afatinib and osimertinib (group A) or other chemotherapy (group B) between October 2014 and 2019, across 16 hospitals in South Korea were reviewed. The primary outcome, time on treatment (TOT), secondary outcome, and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model. Results Of the 737 patients who received frontline afatinib treatment, 324 with complete records were selected (group A: 126, group B: 198). All patients in group A were T790M positive after afatinib, while patients in group B were all negative or unknown. The median TOT was 35.4 months (95% confidence interval [CI]: 27.7-45.6) in group A and 20.8 months (95% CI: 19.4-24.0) in group B. The median TOT with afatinib was 13.0 months (95% CI: 12.0-13.9) overall and 15.7 months (95% CI: 13.9-17.3) in group A. The 2- and 3-year survival rates were 86.0 and 69.3% in group A and 75.9 and 55.3% in group B, respectively. Conclusion Sequential afatinib and osimertinib treatment resulted in better survival rates than treatment with afatinib followed by other chemotherapies.
Author(s)
최창민Chan Kwon ParkCheol-Kyu ParkJeong Eun LeeJeong Seon RyuKye Young LeeMi-Hyun KimSang Hoon LeeSei Hoon YangSeong Hoon YoonSeung Hun JangSeung Joon KimShin Yup LeeSung Yong LeeTae Won JangTaeyun KimYoon Soo Chang
Issued Date
2021
Type
Article
Keyword
afatinibCancerCancer therapiesCare and treatmentChemotherapyData collectionEGFREpidermal growth factorEpidermal growth factor receptorsGenetic aspectsLung cancerLung cancerNon-small cellMetastasisMutationNon-small cell lung carcinomaNSCLCOncologyExperimentalosimertinibPatientsProtein-tyrosine kinaseRankingsreal‐world dataRemission (Medicine)ResearchSmall cell lung carcinomaTyrosine
DOI
10.1002/cam4.4127
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7136
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_fbb820ad007b4aaaa5c7f065285aa49f&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Sequential%20treatment%20of%20afatinib%20and%20osimertinib%20or%20other%20regimens%20in%20patients%20with%20advanced%20non-small-cell%20lung%20cancer%20harboring%20EGFR%20mutations:%20Results%20from%20a%20real-world%20study%20in%20South%20Korea&offset=0&pcAvailability=true
Publisher
CANCER MEDICINE
Location
미국
Language
영어
ISSN
2045-7634
Citation Volume
10
Citation Number
17
Citation Start Page
5809
Citation End Page
5822
Appears in Collections:
Medicine > Medicine
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