Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;13(14):2057-2063.
doi: 10.1111/1759-7714.14528. Epub 2022 Jun 6.

Survival benefits from afatinib compared with gefitinib and erlotinib among patients with common EGFR mutation in first-line setting

Wang Chun Kwok  1 , James Chung Man Ho  1 , Terence Chi Chun Tam  1 , Mary Sau Man Ip  1 , David Chi Leung Lam  1
Affiliations

Survival benefits from afatinib compared with gefitinib and erlotinib among patients with common EGFR mutation in first-line setting

Wang Chun Kwok et al. Thorac Cancer. 2022 Jul.

Abstract

Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are recommended as first-line treatment in non-small cell lung cancer (NSCLC) patients with sensitizing EGFR mutations. The sequential use of different EGFR-TKIs has been reported to demonstrate improvement in overall survival of NSCLC patients with EGFR mutations. There are limited reports on comparisons between regimens with first-line use of afatinib, gefitinib or erlotinib, followed by osimertinib upon disease progression with acquired T790M mutation.

Methods: A retrospective cohort study of Chinese patients with metastatic NSCLC harboring EGFR mutations who received first-line gefitinib, erlotinib or afatinib treatment, followed by osimertinib upon disease progression with acquired T790M mutation, was conducted. The differences in overall survival (OS) and progression-free survival (PFS) with first-line EGFR-TKI (PFS1) and time to second objective disease progression (PFS2) were compared among patients on different first-line EGFR-TKIs.

Results: Among 155 patients, 101 (65.2%), 38 (24.5%) and 16 (10.3%) patients were on first-line gefitinib, erlotinib or afatinib, respectively. Patients treated with afatinib in the first-line setting had significantly longer OS compared with those on gefitinib or erlotinib, while the PFS1 and PFS2 were longer for patients on afatinib but did not reach statistical significance.

Conclusions: First-line afatinib, followed by osimertinib upon disease progression with T790M mutation, demonstrated significantly longer OS compared to that using other EGFR-TKI in the first-line setting.

Keywords: T790M; afatinib; erlotinib; gefitinib; osimertinib.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Overall survival for patients on different first‐line EGFR‐TKI.
FIGURE 2
FIGURE 2
Progression‐free survival for patients on different first‐line EGFR‐TKI.
FIGURE 3
FIGURE 3
Time to second objective disease progression for patients on different first‐line EGFR‐TKI.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Yatabe Y, Kerr KM, Utomo A, Rajadurai P, Tran VK, Du X, et al. EGFR mutation testing practices within the Asia Pacific region: results of a multicenter diagnostic survey. J Thorac Oncol. 2015;10(3):438–45. - PMC - PubMed
    1. Planchard D, Popat S, Kerr K, Novello S, Smit EF, Faivre‐Finn C, et al. Correction to: “metastatic non‐small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow‐up”. Ann Oncol. 2019;30(5):863–70. - PubMed
    1. Kim T, Jang TW, Choi CM, Kim MH, Lee SY, Park CK, et al. 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. Cancer Med. 2021;10(17):5809–22. - PMC - PubMed
    1. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, Wang C, et al. Erlotinib versus chemotherapy as first‐line treatment for patients with advanced EGFR mutation‐positive non‐small‐cell lung cancer (OPTIMAL, CTONG‐0802): a multicentre, open‐label, randomised, phase 3 study. Lancet Oncol 2011;12(8):735–42. - PubMed
    1. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, et al. Final overall survival results from a randomised, phase III study of erlotinib versus chemotherapy as first‐line treatment of EGFR mutation‐positive advanced non‐small‐cell lung cancer (OPTIMAL, CTONG‐0802). Ann Oncol 2015;26(9):1877–83. - PubMed

Publication types

MeSH terms