A real-world cohort study of first-line afatinib in patients with EGFR-mutant advanced non-small cell lung cancer in Vietnam
In: BMC Cancer, Jg. 24 (2024), Heft 1, S. 1-10
Online
academicJournal
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Abstract Background This study aimed to evaluate the efficacy and side effects of first-line afatinib treatment in a real-world setting in Vietnam. Methods This retrospective study was conducted across nine hospitals in Vietnam. Advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients who received afatinib as first-line therapy between April 2018 and June 2022 were included, and patient medical records were reviewed. Key outcomes were overall response rate (ORR), time-to-treatment failure (TTF), and tolerability. Results A total of 343 patients on first-line afatinib were eligible for the study. EGFR exon 19 deletion (Del19) alone was detected in 46.9% of patients, L858R mutation alone in 26.3%, and other uncommon EGFR mutations, including compound mutations, in 26.8%. Patients with brain metastases at baseline were 25.4%. Patients who received 40 mg, 30 mg, and 20 mg as starting doses of afatinib were 58.6%, 39.9%, and 1.5%, respectively. The ORR was 78.1% in the overall population, 82.6% in the Del19 mutation subgroup, 73.3% in the L858R mutation subgroup, and 75.0% in the uncommon mutation subgroup (p > 0.05). The univariate and multivariate analyses indicate that the ORR increased when the starting dose was 40 mg compared to starting doses below 40 mg (83.9% vs. 74.3%, p = 0.034). The median TTF (mTTF) was 16.7 months (CI 95%: 14.8–18.5) in all patients, with a median follow-up time of 26.2 months. The mTTF was longer in patients in the common EGFR mutation subgroup (Del19/L858R) than in those in the uncommon mutation subgroup (17.5 vs. 13.8 months, p = 0.045) and in those without versus with brain metastases at baseline (17.5 vs. 15.1 months, p = 0.049). There were no significant differences in the mTTF between subgroups based on the starting dose of 40 mg and 0.05). The most common treatment-related adverse events (any grade/grade ≥ 3) were diarrhea (55.4%/3.5%), rash (51.9%/3.2%), paronychia (35.3%/5.0%), and stomatitis (22.2%/1.2%). Conclusions Afatinib demonstrated clinical effectiveness and good tolerability in Vietnamese EGFR-mutant NSCLC patients. In our real-world setting, administering a starting dose below 40 mg might result in a reduction in ORR; however, it might not have a significant impact on TTF.
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A real-world cohort study of first-line afatinib in patients with EGFR-mutant advanced non-small cell lung cancer in Vietnam
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Autor/in / Beteiligte Person: | Cam Phuong Pham ; Thi Thai Hoa Nguyen ; Anh Tu Do ; Tuan Khoi Nguyen ; Thi Anh Thu Hoang ; Tuan Anh Le ; Dinh Thy Hao Vuong ; Dac Nhan Tam Nguyen ; Van Khiem Dang ; Thi Oanh Nguyen ; Van Luan Pham ; Minh Hai Nguyen ; Thi Huyen Trang Vo ; Hung Kien Do ; Ha Thanh Vu ; Thi Thuy Hang Nguyen ; Van Thai Pham ; Le Huy Trinh ; Khac Dung Nguyen ; Hoang Gia Nguyen ; Cong Minh Truong ; Tran Minh Chau Pham ; Thi Bich Phuong Nguyen |
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Zeitschrift: | BMC Cancer, Jg. 24 (2024), Heft 1, S. 1-10 |
Veröffentlichung: | BMC, 2024 |
Medientyp: | academicJournal |
ISSN: | 1471-2407 (print) |
DOI: | 10.1186/s12885-024-11891-w |
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