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. 2021 Sep;10(17):5809-5822.
doi: 10.1002/cam4.4127. Epub 2021 Jul 13.

Sequential treatment of afatinib and osimertinib or other regimens in patients with advanced non-small-cell lung cancer harboring EGFR mutations: Results from a real-world study in South Korea

Taeyun Kim  1 , Tae Won Jang  2 , Chang Min Choi  3 , Mi-Hyun Kim  4 , Sung Yong Lee  5 , Cheol-Kyu Park  6 , Yoon Soo Chang  7 , Kye Young Lee  8 , Seung Joon Kim  9 , Sei Hoon Yang  10 , Jeong Seon Ryu  11 , Jeong Eun Lee  12 , Shin Yup Lee  13 , Chan Kwon Park  14 , Sang Hoon Lee  15 , Seung Hun Jang  16 , Seong Hoon Yoon  17
Affiliations

Sequential treatment of afatinib and osimertinib or other regimens in patients with advanced non-small-cell lung cancer harboring EGFR mutations: Results from a real-world study in South Korea

Taeyun Kim et al. Cancer Med. 2021 Sep.

Abstract

Objectives: The optimal sequence for the administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for treating non-small cell lung cancer (NSCLC) is still unclear. This study aimed to evaluate the efficacy of sequential afatinib and osimertinib treatment in patients with NSCLC harboring EGFR mutations.

Materials and methods: Electronic records of patients with EGFR-mutated NSCLC, who were administered afatinib and osimertinib (group A) or other chemotherapy (group B) between October 2014 and 2019, across 16 hospitals in South Korea were reviewed. The primary outcome, time on treatment (TOT), secondary outcome, and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model.

Results: Of the 737 patients who received frontline afatinib treatment, 324 with complete records were selected (group A: 126, group B: 198). All patients in group A were T790M positive after afatinib, while patients in group B were all negative or unknown. The median TOT was 35.4 months (95% confidence interval [CI]: 27.7-45.6) in group A and 20.8 months (95% CI: 19.4-24.0) in group B. The median TOT with afatinib was 13.0 months (95% CI: 12.0-13.9) overall and 15.7 months (95% CI: 13.9-17.3) in group A. The 2- and 3-year survival rates were 86.0 and 69.3% in group A and 75.9 and 55.3% in group B, respectively.

Conclusion: Sequential afatinib and osimertinib treatment resulted in better survival rates than treatment with afatinib followed by other chemotherapies.

Keywords: EGFR; NSCLC; afatinib; osimertinib; real-world data.

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Conflict of interest statement

no conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) Overall time‐on‐treatment (TOT) for first‐ and second‐line treatments in all patients (n = 324) with advanced NSCLC harboring EGFR mutations. (B) Overall TOT, using osimertinib (group A, n = 126) and other medications (group B, n = 198) as second‐line treatment
FIGURE 2
FIGURE 2
(A) Time‐on‐treatment (TOT) for first‐line treatment with afatinib in all patients (n = 324) with advanced NSCLC harboring EGFR mutations. (B) TOT with afatinib, when osimertinib (group A, n = 126) and other medications (group B, n = 198) are used as second‐line treatment
FIGURE 3
FIGURE 3
Multivariate Cox proportional hazards regression analysis of factors affecting time on afatinib treatment in all patients (n = 324) with advanced NSCLC harboring EGFR mutations
FIGURE 4
FIGURE 4
Multivariate Cox proportional hazards regression analysis of factors affecting the time on first‐line afatinib treatment in patients with advanced NSCLC, harboring EGFR mutations, and receiving osimertinib as a second‐line treatment (n = 126)
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References

    1. Jung KW, Won YJ, Kong HJ, Lee ES. Prediction of cancer incidence and mortality in Korea, 2018. Cancer Res Treat. 2018;50(2):317–323. - PMC - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. - PubMed
    1. Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31(27):3327–3334. - PubMed
    1. Park K, Tan E‐H, O'Byrne K, et al. Afatinib versus gefitinib as first‐line treatment of patients with EGFR mutation‐positive non‐small‐cell lung cancer (LUX‐Lung 7): a phase 2B, open‐label, randomised controlled trial. Lancet Oncol. 2016;17(5):577–589. - PubMed
    1. Arcila ME, Oxnard GR, Nafa K, et al. Rebiopsy of lung cancer patients with acquired resistance to EGFR inhibitors and enhanced detection of the T790M mutation using a locked nucleic acid‐based assay. Clin Cancer Res. 2011;17(5):1169–1180. - PMC - PubMed

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