PMID- 34961817
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 1687-8450 (Print)
IS  - 1687-8469 (Electronic)
IS  - 1687-8450 (Linking)
VI  - 2021
DP  - 2021
TI  - Efficacy and Safety of Afatinib in the Treatment of Advanced Non-Small-Cell Lung 
      Cancer with EGFR Mutations: A Meta-Analysis of Real-World Evidence.
PG  - 8736288
LID - 10.1155/2021/8736288 [doi]
LID - 8736288
AB  - INTRODUCTION: The purpose of this study was to explore the efficacy and safety of 
      afatinib in advanced non-small-cell lung cancer (NSCLC) patients with epidermal 
      growth factor receptor (EGFR) mutations based on real-world evidence. MATERIALS 
      AND METHODS: Eligible real-world studies were identified from PubMed, Cochrane 
      Library, and Embase. Cochrane guidelines were used to assess the quality of 
      included studies. Cochran's Q test and I(2) statistics were used for the 
      heterogeneity analysis. RESULTS: Twenty-five studies were included in this 
      meta-analysis; nine studies were included in the qualitative descriptive 
      analysis. The summarized disease control rate (DCR) was 87.6% (81.5%, 92.7%), and 
      the overall response rate (ORR) was 58.9% (48.8%, 68.7%). The pooled median 
      progression-free survival (PFS) was 12.4 (10.3, 14.5) months, mean time to 
      failure (TTF) was 15.4 (13.6, 17.2) months, and median overall survival (OS) was 
      31.6 (26.7, 36.5) months. The total incidences of adverse events (AEs) for skin 
      rashes, diarrhea, paronychia, and mucositis were 71.4% (64.4%, 77.9%), 70.4% 
      (60.1%, 79.8%), 52.1% (41.9, 62.3%), and 36.5% (29.5%, 43.8%), respectively. The 
      incidences of severe adverse events (SAEs, Grade >/=3) for diarrhea, skin rashes, 
      paronychia, and mucositis were 9.7% (6.8%, 13.1%), 5.8% (4.5%, 7.2%), 3.8% (2.0%, 
      6.2%), and 2.1% (1.0%, 3.6%), respectively. Differences in PFS and OS between the 
      afatinib non-full-dose (<40 mg) and full-dose (>40 mg) groups were not 
      significant (P > 0.05). However, the ORR in the full-dose group was 78.5% (66.7%, 
      88.4%), which was significantly higher than that in the non-full-dose group 
      (67.8% [56.8%, 77.9%]). CONCLUSION: The efficacy and safety of afatinib has been 
      confirmed by real-world evidence in advanced NSCLC with EGFR mutation, consistent 
      with randomized controlled trial results. In real-world setting, 
      tolerability-guided dose adjustment might not affect the afatinib efficacy.
CI  - Copyright (c) 2021 Lemeng Zhang et al.
FAU - Zhang, Lemeng
AU  - Zhang L
AUID- ORCID: 0000-0002-2239-7307
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Luo, Yongzhong
AU  - Luo Y
AUID- ORCID: 0000-0003-0770-0854
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Chen, Jianhua
AU  - Chen J
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Cheng, Tianli
AU  - Cheng T
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Yang, Hua
AU  - Yang H
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Pan, Changqie
AU  - Pan C
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Li, Haitao
AU  - Li H
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
FAU - Jiang, Zhou
AU  - Jiang Z
AD  - Thoracic Medicine Department 1, Hunan Cancer Hospital, Changsha 410013, Hunan 
      Province, China.
LA  - eng
PT  - Journal Article
DEP - 20211218
PL  - Egypt
TA  - J Oncol
JT  - Journal of oncology
JID - 101496537
PMC - PMC8710163
COIS- The authors declare that they have no conflicts of interests.
EDAT- 2021/12/29 06:00
MHDA- 2021/12/29 06:01
PMCR- 2021/12/18
CRDT- 2021/12/28 06:35
PHST- 2021/10/21 00:00 [received]
PHST- 2021/11/29 00:00 [accepted]
PHST- 2021/12/28 06:35 [entrez]
PHST- 2021/12/29 06:00 [pubmed]
PHST- 2021/12/29 06:01 [medline]
PHST- 2021/12/18 00:00 [pmc-release]
AID - 10.1155/2021/8736288 [doi]
PST - epublish
SO  - J Oncol. 2021 Dec 18;2021:8736288. doi: 10.1155/2021/8736288. eCollection 2021.