110P - Afatinib for patients with advanced NSCLC pretreated with chemotherapy and an EGFR tyrosine kinase inhibitor: Retrospective analysis of the Swiss A...

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Non-Small-Cell Lung Cancer, Locally Advanced
Cancer Immunology and Immunotherapy
Lung and other Thoracic Tumours
Presenter Michelle Ehmann
Citation Annals of Oncology (2017) 28 (suppl_2): ii28-ii51. 10.1093/annonc/mdx091
Authors M. Ehmann1, L. Wannesson2, M. Pless3, M. Früh4, O. Gautschi5, A. Curioni-Fontecedro6, D. Betticher7, M. Mark8, A. Ochsenbein9, S.I. Rothschild10
  • 1Department Internal Medicine, Medical Oncology, Universitätsspital Basel, 4031 - Basel/CH
  • 2IOSI Istituto Oncologico Svizzera Italiana Ospedale Regionale Bellinzona e Valli, Bellinzona/CH
  • 3Kantonsspital Winterthur, Winterthur/CH
  • 4Department Of Oncology And Hematology, Kantonsspital St. Gallen, St. Gallen/CH
  • 5Department Of Medical Oncology, Cantonal Hospital Lucerne, Luzern/CH
  • 6Department Of Hematology And Oncology, Clinic Of Oncology, University Hospital Zürich, 8091 - Zürich/CH
  • 7HFR - Hopital Cantonal, Fribourg/CH
  • 8Kantonsspital Graubünden, Chur/CH
  • 9Inselspital Bern, Bern/CH
  • 10Department Internal Medicine, Medical Oncology, Universitätsspital Basel, Basel/CH

Abstract

Background

Epidermal growth factor receptor (EGFR) mutations are found in 12-15% of lung adenocarcinoma patients in European countries. Afatinib is a second-generation EGFR tyrosine kinase inhibitor (TKI) and is approved for stage IV NSCLC patients with common EGFR mutations. Based on the LUX-Lung 1 trial a named patient program for afatinib was initiated in Switzerland. We thus aimed to evaluate afatinib activity in patients which where previous treated with chemotherapy and first-generation TKIs.

Methods

This multicentre retrospective analysis was performed in 11 institutions in Switzerland. We reviewed clinical records of patients included in the afatinib NPP.

Results

Between 03/2011 and 04/2014 a total of 69 patients were included in the NPP. Baseline characteristics were obtained from all these patients. Follow-up data were accessible from 41 patients. Median age of the population was 63 years (range, 46-79). 68% of patients were female and 28% were never smoker. Adenocarcinoma was the predominant histological subtype (93%). 56 patients (81%) had a proven EGFR mutation. Of those, 29 patients (52%) had a deletion 19, 16 patients (29%) had a L858R mutation in exon 21. A T790M mutation was detected in 10 patients (18%). 50 patients (73%) received treatment with erlotinib and 14 patients (20%) with gefitinib before inclusion in the NPP. 31 patients were evaluable for response assessment by RECIST 1.1. One patient (3.2%) achieved a complete remission, 4 patients (12.9%) showed a partial remission and 3 patients (9.7%) disease stabilization. Mean duration of afatinib therapy was 200 days (95% CI 146-255). Mean overall survival (OS) from diagnosis of metastatic NSCLC was 17.2 months (95%CI 11.9-22.6). In multivariate analysis, EGFR mutation was associated with response to afatinib.

Conclusions

This study confirms the activity of afatinib in pretreated lung adenocarcinoma. The benefit is larger in patients with EGFR mutation positive tumors and mainly in those with classical mutations (deletion 19 or point mutation L858R in exon 21).

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Unrestricted educational grant by Boehringer-Ingelheim

Disclosure

S.I. Rothschild: Advisory Board Boehringer-Ingelheim (honorary paid to the institution). All other authors have declared no conflicts of interest.