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Real-world first-line afatinib for advanced EGFR mutation-positive non-small cell lung cancer in Korea: updated survival data

Authors
 Juwhan Choi  ;  Chang Min Choi  ;  Yoon Soo Chang  ;  Kye Young Lee  ;  Seung Joon Kim  ;  Sei Hoon Yang  ;  Jeong Seon Ryu  ;  Jeong Eun Lee  ;  Shin Yup Lee  ;  Ji Young Park  ;  Young-Chul Kim  ;  In-Jae Oh  ;  Chi Young Jung  ;  Sang Hoon Lee  ;  Seong Hoon Yoon  ;  Sung Yong Lee  ;  Tae Won Jang 
Citation
 TRANSLATIONAL LUNG CANCER RESEARCH, Vol.12(11) : 2275-2282, 2023-11 
Journal Title
TRANSLATIONAL LUNG CANCER RESEARCH
ISSN
 2218-6751 
Issue Date
2023-11
Keywords
Afatinib ; epidermal growth factor receptor (EGFR) ; first-line ; non-small cell lung cancer (NSCLC) ; real-world
Abstract
Background: Data from clinical trials and real-world studies show that afatinib is effective in treating non-small cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene. A previous analysis of patients enrolled in the Korean Academy of Tuberculosis and Respiratory Disease (KATRD) EGFR cohort showed that first-line afatinib was well tolerated and effectiveness results were encouraging. At the time of the previous analysis, survival data were not mature. Here we briefly present updated survival data from the cohort.Methods: The study was a retrospective, multicenter (15 sites) review of electronic records of Korean adult patients (aged >20 years) with advanced EGFR mutation-positive NSCLC who initiated first-line afatinib (N=421). Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier survival curves.Results: Overall, median PFS was 20.2 months and median OS was 48.6 months. OS rates at 36 and 60 months were 60.1% and 42.3%, respectively. Presence vs. absence of baseline brain metastases was associated with significantly reduced median PFS (14.9 vs. 28.6 months; P<0.001) and median OS (32.2 vs. 65.6 months; P<0.001). The presence of common baseline EGFR mutations (Del19, L858R) was associated with significantly prolonged median OS (49.6 vs. 30.1 months; P=0.017). In patients stratified by the presence/absence of T790M EGFR mutation, the T790M mutation was associated with significantly reduced median PFS (P=0.0005) but there was no significant difference between groups in survival (P=0.263). There were no significant differences in PFS or OS for patients stratified by afatinib dose reduction or by age group (<70 vs. >= 70 years).Conclusions: Afatinib was effective in Korean patients with EGFR mutation-positive NSCLC with median OS over 4 years. The presence of baseline brain metastases and/or uncommon EGFR mutations were associated with reduced survival. In the absence of baseline brain metastases, median OS was more than 5 years.
Files in This Item:
T999202641.pdf Download
DOI
10.21037/tlcr-23-383
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198441
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