PMID- 35813735
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 14
IP  - 6
DP  - 2022 Jun
TI  - Afatinib 30 mg in the treatment of common and uncommon EGFR-mutated advanced lung 
      adenocarcinomas: a retrospective, single-center, longitudinal study.
PG  - 2169-2177
LID - 10.21037/jtd-22-507 [doi]
AB  - BACKGROUND: Afatinib 30 mg has been proved to be with comparable efficacy but 
      more tolerable than the dose of 40 mg for Asian patients with non-small cell lung 
      cancer (NSCLC). This study aimed to investigate the clinical outcomes of afatinib 
      at 30 mg/d in the treatment of advanced lung adenocarcinomas (LAD) with common 
      and uncommon epidermal growth factor receptor (EGFR) mutations. METHODS: 
      EGFR-mutated advanced LAD patients receiving afatinib (30 mg/d) from January 2017 
      to November 2021 were retrospectively included. EGFR status was classified into 
      three subtypes, namely common mutations including exon 19 deletions (19del) and 
      exon 21 L858R (21L858R), uncommon mutations including G719X, L861Q, S768I, and 
      complex mutations, and separately exon 20 insertions (20ins). Progression-free 
      survival (PFS), objective response rate (ORR), disease control rate (DCR) and 
      adverse events (AEs) were analyzed during regular follow-up. RESULTS: The overall 
      median PFS of totally 58 included patients was 9.83 [95% confidence index (CI): 
      5.76-13.91] months. The number of patients with common, uncommon, and 20ins 
      mutations was 32 (55.2%), 19 (32.8%) and 7 (12.1%), respectively. Baseline 
      characteristics did not differ significantly among the three subtypes. The 
      corresponding median PFS was 13.97 (12.06-15.89), 8.48 (0.32-16.64), and 3.78 
      (1.93-5.64) months, respectively (P=0.002). In the first-line setting, patients 
      with common and uncommon mutations had a significantly longer PFS compared to 
      those with 20ins [14.53 (13.53-15.53) vs. 10.39 (4.87-15.91) vs. 2.37 (0.00-5.11) 
      months, P<0.001]. The first-line ORR showed significant differences among the 
      three subtypes (60% vs. 80% vs. 0.0%, P=0.023). All-grade AEs occurred in 22 
      patients (37.9%). AEs >/= grade 3 mainly included diarrhea (8.6%), and none of the 
      patients discontinued treatment due to severe AEs. CONCLUSIONS: Afatinib at 30 
      mg/d is associated with a favorable efficacy and tolerability in the treatment of 
      advanced LAD with common and major uncommon EGFR mutations except 20ins. Further 
      large-scale prospective studies are warranted to confirm our findings.
CI  - 2022 Journal of Thoracic Disease. All rights reserved.
FAU - Qian, Jie
AU  - Qian J
AD  - Department of Emergency Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Ye, Xuanting
AU  - Ye X
AD  - Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 
      China.
FAU - Huang, Aimi
AU  - Huang A
AD  - Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Qin, Ruoyan
AU  - Qin R
AD  - Department of Oncology, Longhua Hospital Shanghai University of Traditional 
      Chinese Medicine, Shanghai, China.
FAU - Cai, Yuqing
AU  - Cai Y
AD  - Department of Oncology, Longhua Hospital Shanghai University of Traditional 
      Chinese Medicine, Shanghai, China.
FAU - Xue, Yiqian
AU  - Xue Y
AD  - Department of Oncology, Longhua Hospital Shanghai University of Traditional 
      Chinese Medicine, Shanghai, China.
FAU - Zhang, Shi
AU  - Zhang S
AD  - Department of Oncology, Longhua Hospital Shanghai University of Traditional 
      Chinese Medicine, Shanghai, China.
FAU - Wang, Weimin
AU  - Wang W
AD  - Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Xiong, Liwen
AU  - Xiong L
AD  - Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Gu, Aiqin
AU  - Gu A
AD  - Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC9264103
OTO - NOTNLM
OT  - Afatinib
OT  - dose
OT  - epidermal growth factor receptor mutation (EGFR mutation)
OT  - lung adenocarcinomas (LAD)
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-22-507/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/07/12 06:00
MHDA- 2022/07/12 06:01
PMCR- 2022/06/01
CRDT- 2022/07/11 04:06
PHST- 2022/03/28 00:00 [received]
PHST- 2022/06/09 00:00 [accepted]
PHST- 2022/07/11 04:06 [entrez]
PHST- 2022/07/12 06:00 [pubmed]
PHST- 2022/07/12 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - jtd-14-06-2169 [pii]
AID - 10.21037/jtd-22-507 [doi]
PST - ppublish
SO  - J Thorac Dis. 2022 Jun;14(6):2169-2177. doi: 10.21037/jtd-22-507.