PMID- 34048189 OWN - NLM STAT- MEDLINE DCOM- 20211125 LR - 20211125 IS - 2476-762X (Electronic) IS - 1513-7368 (Print) IS - 1513-7368 (Linking) VI - 22 IP - 5 DP - 2021 May 1 TI - Effectiveness and Tolerability of First-Line Afatinib for Advanced EGFR-Mutant Non-Small Cell Lung Cancer in Vietnam. PG - 1581-1590 LID - 89610 [pii] LID - 10.31557/APJCP.2021.22.5.1581 [doi] AB - BACKGROUND: We aimed to evaluate the effectiveness and tolerability of Afatinib as first-line treatment of advanced epidermal growth factor receptor (EGFR) mutant non small cell lung cancer (NSCLC) in a real-world setting. PATIENTS AND METHODS: This is a retrospective study of Vietnamese patients with advanced EGFR-mutant NSCLC treated with first-line afatinib at the National Cancer Hospital from 1st January 2018 to 31st October 2020. Patients' demographic, clinical and treatment data were captured. Objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF) and tolerability were evaluated. We used Kaplan-Meier curve and log-rank test for survival, and Cox regression model for multivariate analysis. RESULTS: A total of 44 patients were included. Common EGFR mutations (Del 19/L858R) were detected in 61% patients. Fifty percent of patients with uncommon mutations had compound mutations of G719X, L861Q and S768I. The ORR was 75% while DCR rate was 98%. The median TTF was 12.3 months (95% CI: 7.2-17.3); the mTTFs were 12.3 and 10.8 months for patients with common and uncommon mutations (p = 0.001), respectively, and 14.0 and 7.5 months for patients with Del 19 and L858R mutations (p = 0.067), respectively. Afatinib 30 mg once daily was the most common starting (77%) and maintenance (64%) doses. The mTTFs were 12.3 and 7.5 months for patients with 30 mg starting dose vs 40 mg dose (p = 0.256), respectively. Diarrhea, skin rash, paronychia and fatigue were observed in 32%, 30%, 25% and 9%, respectively. There was no grade 4 toxicity except three patients with grade 3 paronychia. CONCLUSIONS: First-line afatinib is beneficial for Vietnamese patients with advanced EGFR-mutant NSCLC with a good response rate and prolonged TTF with manageable adverse event profile. Baseline brain metastasis status and starting doses do not significantly impact TTF.
. FAU - Vu, Thanh Ha AU - Vu TH AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Nguyen, Hoa Thi Thai AU - Nguyen HTT AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. AD - Department of Oncology, Vietnam University of Traditional Medicine, Hanoi, Vietnam. FAU - Dao, Linh Khanh AU - Dao LK AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Duong, Chi Khanh AU - Duong CK AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Nguyen, Cao Van AU - Nguyen CV AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Doan, Tuyet Thi AU - Doan TT AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Nguyen, Hang Thi Thuy AU - Nguyen HTT AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Hoang, Hung Huy AU - Hoang HH AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. AD - Department of Oncology, Hanoi Medical University, Hanoi, Vietnam. FAU - Dinh, Dung Khac AU - Dinh DK AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Le, Giang Vinh AU - Le GV AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Vu, Thanh Thi AU - Vu TT AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. FAU - Truong, Minh Cong AU - Truong MC AUID- ORCID: 0000-0003-3953-6729 AD - Department of Oncology, Hanoi Medical University, Hanoi, Vietnam. FAU - Nguyen, Long Thanh AU - Nguyen LT AUID- ORCID: 0000-0002-0601-1013 AD - Department of Oncology, Hanoi Medical University, Hanoi, Vietnam. LA - eng PT - Journal Article DEP - 20210501 PL - Thailand TA - Asian Pac J Cancer Prev JT - Asian Pacific journal of cancer prevention : APJCP JID - 101130625 RN - 0 (Antineoplastic Agents) RN - 41UD74L59M (Afatinib) RN - EC 2.7.10.1 (EGFR protein, human) RN - EC 2.7.10.1 (ErbB Receptors) SB - IM MH - Adult MH - Afatinib/*therapeutic use MH - Aged MH - Antineoplastic Agents/*therapeutic use MH - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics/pathology MH - ErbB Receptors/antagonists & inhibitors/genetics MH - Female MH - Follow-Up Studies MH - Humans MH - Lung Neoplasms/*drug therapy/genetics/pathology MH - Male MH - Maximum Tolerated Dose MH - Middle Aged MH - *Mutation MH - Prognosis MH - Retrospective Studies MH - Survival Rate PMC - PMC8408372 OTO - NOTNLM OT - EGFR mutation OT - advanced stage OT - non small cell lung cancer (NSCLC) OT - real-world OT - second generation EGFR TKI COIS- The Authors declare that there is no conflict of interest. EDAT- 2021/05/29 06:00 MHDA- 2021/11/26 06:00 PMCR- 2021/07/01 CRDT- 2021/05/28 13:26 PHST- 2021/03/28 00:00 [received] PHST- 2021/05/28 13:26 [entrez] PHST- 2021/05/29 06:00 [pubmed] PHST- 2021/11/26 06:00 [medline] PHST- 2021/07/01 00:00 [pmc-release] AID - 89610 [pii] AID - 10.31557/APJCP.2021.22.5.1581 [doi] PST - epublish SO - Asian Pac J Cancer Prev. 2021 May 1;22(5):1581-1590. doi: 10.31557/APJCP.2021.22.5.1581.