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Real-world analysis of first-line afatinib in patients with EGFR-mutant non-small cell lung cancer and brain metastasis: survival and prognostic factors
DC Field | Value | Language |
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dc.contributor.author | 장윤수 | - |
dc.contributor.author | 이상훈 | - |
dc.date.accessioned | 2024-03-22T06:10:36Z | - |
dc.date.available | 2024-03-22T06:10:36Z | - |
dc.date.issued | 2023-06 | - |
dc.identifier.issn | 2218-6751 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/198437 | - |
dc.description.abstract | Background: Overall survival (OS) in patients with non-small cell lung cancer (NSCLC) and brain metastases (BMs) is poor. We aimed to identify prognostic factors and ascertain treatment outcomes of first-line afatinib for patients with epidermal growth factor receptor (EGFR)-mutant NSCLC with BM in a real-world setting. Methods: This retrospective observational study reviewed electronic records of patients with EGFR-mutant NSCLC who received first-line afatinib treatment between October 2014 and October 2019 in 16 hospitals across South Korea. The Kaplan-Meier method estimated time on treatment (TOT) and OS; multivariate analyses were performed using Cox proportional hazards (PH) models. Results: Among 703 patients who received first-line afatinib, 262 (37.3%) had baseline BM. Of 441 patients without baseline BM, 92 (20.9%) developed central nervous system (CNS) failure. Compared with patients without CNS failure, those with CNS failure during afatinib treatment were younger (P=0.012), had a higher Eastern Cooperative Oncology Group (ECOG) performance status (PS) (P<0.001), increased metastatic site involvement (P<0.001), advanced stage disease (P<0.001), with liver metastasis (P=0.008) and/ or bone metastasis (P<0.001) at baseline. Cumulative incidence of CNS failure in years 1, 2 and 3 was 10.1%, 21.5% and 30.0%, respectively. In multivariate analysis, cumulative incidence was significantly higher in patients with ECOG PS ≥2 (P<0.001), uncommon EGFR mutations (P=0.001), and no baseline pleural metastasis (P=0.017). Median TOT was 16.0 months (95% CI: 14.8–17.2) and, in patients with CNS failure, without CNS failure, and with baseline BM was 12.2, 18.9, and 14.1 months, respectively (P<0.001). Median OS was 52.9 months (95% CI: 45.4–60.3) and, in patients with CNS failure, without CNS failure, and with baseline BM was 29.1, 67.3 and 48.5 months, respectively (P<0.001). Conclusions: First-line afatinib in the real-world setting showed clinically meaningful effectiveness in patients with EGFR-mutant NSCLC and BM. CNS failure was a poor prognostic factor for TOT and OS correlating with younger age, poor ECOG PS, higher metastatic number, advanced disease stage, uncommon EGFR mutations, and baseline liver and/or bone metastases. © 2023 AME Publishing Company. All rights reserved. | - |
dc.description.statementOfResponsibility | open | - |
dc.format | application/pdf | - |
dc.language | English | - |
dc.publisher | Pioneer Bioscience Publishing Company | - |
dc.relation.isPartOf | TRANSLATIONAL LUNG CANCER RESEARCH | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Real-world analysis of first-line afatinib in patients with EGFR-mutant non-small cell lung cancer and brain metastasis: survival and prognostic factors | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Jehun Kim | - |
dc.contributor.googleauthor | Tae Won Jang | - |
dc.contributor.googleauthor | Chang Min Choi | - |
dc.contributor.googleauthor | Mi Hyun Kim | - |
dc.contributor.googleauthor | Sung Yong Lee | - |
dc.contributor.googleauthor | Cheol Kyu Park | - |
dc.contributor.googleauthor | Yoon Soo Chang | - |
dc.contributor.googleauthor | Kye Young Lee | - |
dc.contributor.googleauthor | Seung Joon Kim | - |
dc.contributor.googleauthor | Sei Hoon Yang | - |
dc.contributor.googleauthor | Jeong Seon Ryu | - |
dc.contributor.googleauthor | Jeong Eun Lee | - |
dc.contributor.googleauthor | Shin Yup Lee | - |
dc.contributor.googleauthor | Chan Kwon Park | - |
dc.contributor.googleauthor | Sang Hoon Lee | - |
dc.contributor.googleauthor | Seung Hun Jang | - |
dc.contributor.googleauthor | Seong Hoon Yoon | - |
dc.identifier.doi | 10.21037/tlcr-22-832 | - |
dc.contributor.localId | A03456 | - |
dc.relation.journalcode | J03382 | - |
dc.identifier.eissn | 2226-4477 | - |
dc.identifier.pmid | 37425421 | - |
dc.subject.keyword | Afatinib | - |
dc.subject.keyword | EGFR mutation | - |
dc.subject.keyword | brain metastasis (BM) | - |
dc.subject.keyword | non-small cell lung cancer (NSCLC) | - |
dc.subject.keyword | tyrosine kinase inhibitor (TKI) | - |
dc.contributor.alternativeName | Chang, Yoon Soo | - |
dc.contributor.affiliatedAuthor | 장윤수 | - |
dc.citation.volume | 12 | - |
dc.citation.number | 6 | - |
dc.citation.startPage | 1197 | - |
dc.citation.endPage | 1209 | - |
dc.identifier.bibliographicCitation | TRANSLATIONAL LUNG CANCER RESEARCH, Vol.12(6) : 1197-1209, 2023-06 | - |
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