Young-Chul Kim
Chonnam National University Hwasun Hospital, South Korea
Title: Real world experience of first line Afatinib in non-small cell lung carcinoma
Biography
Biography: Young-Chul Kim
Abstract
Background: Afatinib is one of the second generation epidermal growth factor receptor (EGFR), tyrosine kinase inhibitors that can be used as a first line treatment of non-small cell lung cancer (NSCLC) with activating EGFR mutations.
Methods: We have surveyed on85 cases retrospectively who are treated with afatinib as first line treatment for NSCLC. Afatinib was started from daily dose of 40 or 30 mg, and response, progression survival, overall survival and toxicity were reviewed. Fifty-four male (64%) and 31 female (36%) patients with mean age of 67 years were recruited to this analysis. Patients with brain metastases were 61% (52 cases).
Results: Response rate was 48.2% and 53.9%, when we exclude cases, whose response was not evaluable. Median progression free survival (PFS) was 13.2 months (95% confidence interval, CI 8.8 ~ 17.6). Median overall survival (OS) was 20.5 months (95% CI 15.6~25.4). Afatinib was started from 40 mg daily dose in 69 patients (81%), and started from 30 mg daily dose in 16 patients. However, only 26 cases maintained 40 mg starting dose (30.6%), and dose reductions were made in 59 cases (69.4%). Diarrhea (76.5%) and skin rash (65.9%) followed by paronychia (49.4%) were most frequently observed adverse events in any grades.
Conclusions: Afatinib showed good response in patients with high proportion of male and brain metastases. As dosage reduction was made in 70% without difference in efficacy, PFS and OS between the dosage groups, active dose adjustment are warranted.