PMID- 34011336
OWN - NLM
STAT- MEDLINE
DCOM- 20211118
LR  - 20220603
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 21
IP  - 1
DP  - 2021 May 19
TI  - Osimertinib versus afatinib in patients with T790M-positive, non-small-cell lung 
      cancer and multiple central nervous system metastases after failure of initial 
      EGFR-TKI treatment.
PG  - 172
LID - 10.1186/s12890-021-01539-x [doi]
LID - 172
AB  - BACKGROUND: The purpose of this study was to compare the efficacy of osimertinib 
      (OSI) versus afatinib (AFA) in patients with T790M-positive, non-small-cell lung 
      cancer (NSCLC) and multiple central nervous system (CNS) metastases after failure 
      of initial epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) 
      treatment. METHODS: Consecutive patients with T790M-positive NSCLC and multiple 
      CNS metastases after failure of initial EGFR-TKI treatment were retrospectively 
      identified from our medical institution during 2016-2018 and underwent either 
      oral 80 daily OSI or oral 40 daily AFA every 3 weeks for up to 6 cycles, until 
      disease progression, intolerable adverse events (AEs), or death. The co-primary 
      endpoints were overall survival (OS) and progression-free survival (PFS). 
      RESULTS: The cohort consisted of 124 patients (OSI: n = 60, mean 
      age = 64.24 years [SD: 12.33]; AFA: n = 64, mean age = 64.13 years [SD: 13.72]). 
      After a median follow-up of 24 months (range, 3 to 28), a significant improvement 
      in OS was detected (hazard ratio [HR] 0.59, 95% confidence interval [CI], 
      0.39-0.91; p = 0.0160; median, 13.7 months [95% CI, 11.1-14.8] for OSI vs 
      9.6 months [95% CI, 8.4-10.2] for AFA). The median duration of PFS was 
      significantly longer with OSI than with AFA (HR 0.62; 95% CI, 0.41-0.91; 
      p = 0.014; median, 4.5 months [95% CI, 3.5-5.7] vs 3.9 months [95% CI, 3.1-4.8]). 
      The proportion of grade 3 or higher adverse events (AEs) was lower with OSI 
      (22.4%) than with AFA (39.4%). CONCLUSIONS: In patients with T790M-positive NSCLC 
      and multiple CNS metastases after failure of initial EGFR-TKI treatment, OSI may 
      be associated with significantly improved survival benefit compared with AFA, 
      with a controllable tolerability profile.
FAU - Yang, Yang
AU  - Yang Y
AD  - Hebei Key Laboratory of Cancer Radiotherapy and Chemotherapy, Department of 
      Medical Oncology, Affiliated Hospital of Hebei University, No. 212, Yuhua Dong 
      Road, Lianchi District, Baoding, 071000, Hebei Province, China.
FAU - Liu, Qilong
AU  - Liu Q
AD  - Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun 
      Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 
      510080, China.
FAU - Cao, Lei
AU  - Cao L
AD  - Department of Anaesthesiology, The Central Hospital of Wuhan, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, 430014, China.
FAU - Sun, Wei
AU  - Sun W
AD  - Department of Anaesthesiology, The Central Hospital of Wuhan, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, 430014, China.
FAU - Gu, Xiaowei
AU  - Gu X
AD  - Department of Head and Neck Surgery, Affiliated Hospital of Hebei University, No. 
      212, Yuhua Dong Road, Lianchi District, Baoding, 071000, Hebei Province, China.
FAU - Liu, Bin
AU  - Liu B
AD  - Central Laboratory, Affiliated Hospital of Hebei University, No. 212, Yuhua Dong 
      Road, Lianchi District, Baoding, 071000, Hebei Province, China.
FAU - Xiao, Na
AU  - Xiao N
AD  - Hebei Key Laboratory of Cancer Radiotherapy and Chemotherapy, Department of 
      Medical Oncology, Affiliated Hospital of Hebei University, No. 212, Yuhua Dong 
      Road, Lianchi District, Baoding, 071000, Hebei Province, China.
FAU - Teng, Fei
AU  - Teng F
AD  - Department of Radiotherapy, Affiliated Hospital of Hebei University, No. 212, 
      Yuhua Dong Road, Lianchi District, Baoding, 071000, Hebei Province, China.
FAU - Li, Xiaoli
AU  - Li X
AD  - Hebei Key Laboratory of Cancer Radiotherapy and Chemotherapy, Department of 
      Medical Oncology, Affiliated Hospital of Hebei University, No. 212, Yuhua Dong 
      Road, Lianchi District, Baoding, 071000, Hebei Province, China. 
      lxl800002@163.com.
FAU - Chen, Meiji
AU  - Chen M
AD  - Department of Pediatrics, The First Affiliated Hospital, Sun Yat-Sen University, 
      No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China.
FAU - Yu, Weiguang
AU  - Yu W
AD  - Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-Sen 
      University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, 
      China.
FAU - Lin, Huanyi
AU  - Lin H
AD  - Department of Urinary Surgery, The First Affiliated Hospital, Sun Yat-Sen 
      University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, 
      China. linhyi2@mail.sysu.edu.cn.
FAU - Xu, Guixing
AU  - Xu G
AD  - Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-Sen 
      University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, 
      China. xuguix@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20210519
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Acrylamides)
RN  - 0 (Aniline Compounds)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 3C06JJ0Z2O (osimertinib)
RN  - 41UD74L59M (Afatinib)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Acrylamides/*therapeutic use
MH  - Afatinib/*therapeutic use
MH  - Aged
MH  - Aniline Compounds/*therapeutic use
MH  - Brain Neoplasms/*drug therapy/genetics/secondary
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics/pathology
MH  - ErbB Receptors/genetics
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/genetics/pathology
MH  - Male
MH  - Middle Aged
MH  - Mutation
MH  - Protein Kinase Inhibitors
MH  - Retrospective Studies
MH  - Survival Analysis
PMC - PMC8135149
OTO - NOTNLM
OT  - Afatinib
OT  - Central nervous system
OT  - Metastases
OT  - Non-small-cell lung cancer
OT  - Osimertinib
OT  - Survival
COIS- The authors declare that they have no competing interests.
EDAT- 2021/05/21 06:00
MHDA- 2021/11/19 06:00
PMCR- 2021/05/19
CRDT- 2021/05/20 05:38
PHST- 2020/12/27 00:00 [received]
PHST- 2021/05/11 00:00 [accepted]
PHST- 2021/05/20 05:38 [entrez]
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/11/19 06:00 [medline]
PHST- 2021/05/19 00:00 [pmc-release]
AID - 10.1186/s12890-021-01539-x [pii]
AID - 1539 [pii]
AID - 10.1186/s12890-021-01539-x [doi]
PST - epublish
SO  - BMC Pulm Med. 2021 May 19;21(1):172. doi: 10.1186/s12890-021-01539-x.