Abstract 487P
Background
Afatinib is an irreversible second-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) while gefitinib or erlotinib are reversible first-generation EGFR-TKIs.
Methods
A retrospective analysis of patients with EGFR mutant advanced lung adenocarcinoma receiving first-line afatinib versus gefitinib or erlotinib at University Malaya Medical Centre from 1st January 2015 to 31th December 2018.
Results
Of 113 patients, 24 (21.2%) received afatinib, 63 (55.8%) received gefitinib and 26 (23.0%) received erlotinib in first-line setting. Their demographic and clinical characteristics are shown in the table. Afatinib was used significantly more frequently in patients with rare or complex EGFR mutations (p = 0.005), and more often in patients with symptomatic brain metastases. The median progression-free survival (mPFS) of patients treated with afatinib (13.1 months) was longer than that of patients treated with gefitinib (10.9 months) or erlotinib (7.8 months) (p = 0.479). Patients receiving afatinib had consistently longer PFS than patients receiving gefitinib for the first 17 months and erlotinib for the first 20 months. The overall response rate was higher in patients on afatinib (75.0%) than those on gefitinib (63.5%) or erlotinib (53.8%). There was no difference in the disease control rate. Three patients (2.7%) had severe side-effects while on EGFR-TKI. Of two patients on afatinib, one had grade-3 diarrhea while another had grade 3 stomatitis, rash and paronychia. One patient had grade 3 rash on gefitinib.Table:
487P Clinical characteristic of 113 patients on first-line EGFR-TKI
Characteristics, No (%) | Afatinib (24) | Gefitinib (63) | Erlotinib (26) | p-value | |
---|---|---|---|---|---|
Symp brain mets | No Yes | 17 (70.8) 7 (29.2) | 53 (84.1) 10 (15.9) | 22 (84.6) 4 (15.4) | 0.181 |
EGFR subtype | 19 del 21 L858R Rare/complex | 16 (66.7) 2 (8.3) 6 (25.0) | 39 (61.9) 20 (31.7) 4 (6.3) | 22 (84.6) 3 (11.5) 1 (3.8) | 0.005 |
Side-effect | grade 1-2 grade 3 | 22 (91.7) 2 (8.3) | 62 (98.4) 1 (1.6) | 26 (100) 0 | 0.007 |
Objective response | Yes No | 18 (75.0) 6 (25.0) | 40 (63.5) 23 (36.5) | 14 (53.8) 12 (46.2) | 0.298 |
Disease control | Yes No | 23 (95.8) 1 (4.2) | 59 (93.7) 4 (6.3) | 24 (92.3) 2 (7.7) | 0.872 |
Median PFS | Months Event, No. (%) | 13.1 19 (79.2) | 10.9 49 (77.8) | 7.8 19 (73.1) | 0.479 |
Conclusions
Patients receiving first-line afatinib demonstrated longer mPFS than those on first-line gefitinib or erlotinib. The lack of statistical significance in this study is because of the small number of patients treated with afatinib, more frequent rare or complex EGFR mutations and more symptomatic brain metastases among afatinib treated patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
273P - MALT1- A20 and NF-κB expression pattern in patients with non-Hodgkin lymphomas
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract
274P - Treatment stratification of non-Hodgkin large B-cell lymphoma patients based on the identification of mutational c-MYC gene
Presenter: Raimkul Karakulov
Session: Poster display session
Resources:
Abstract
275P - Primary central nervous system lymphoma treated with high-dose methotrexate and rituximab: Preliminary results in Vietnam
Presenter: Gia Nguyen Hoang
Session: Poster display session
Resources:
Abstract
276P - Chronic myelod leukemia in chronic phase (CML-CP) with lymphadenopathy at diagnosis: A retrospective analysis
Presenter: GEDALA Veni Prasanna
Session: Poster display session
Resources:
Abstract
277P - Characteristics of BCR-ABL rearrangement variants in Pakistani patients with chronic myeloid leukemia and acute lymphocytic leukemia
Presenter: Zeeshan Ahmed
Session: Poster display session
Resources:
Abstract
278P - A systematic literature review of the cost-effectiveness of treatments, costs, and resource use in patients with Burkitt lymphoma
Presenter: Gautamjeet Mangat
Session: Poster display session
Resources:
Abstract
280P - Risk stratification of CML-CP in a real-world scenario, comparison of S.H.E. with rate of fall of BCR/ABL
Presenter: Kundan Mishra
Session: Poster display session
Resources:
Abstract
281P - Selective depletion of tumour-associated SAMHD1 by HSP90 inhibitors enhances the anti-AML effect of cytarabine
Presenter: Jing Sun
Session: Poster display session
Resources:
Abstract
282P - Inhibition of miR-144 and miR-199 promote myeloma pathogenesis via upregulation of versican and FAK/STAT3 signaling
Presenter: Nidh Gupta
Session: Poster display session
Resources:
Abstract
283P - Effect of study-level factors on treatment-free remission rate in patients with chronic myeloid leukemia: A systematic review and meta-analysis
Presenter: Jinhyun Cho
Session: Poster display session
Resources:
Abstract