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
447P - Hypomagnesaemia: An unnoticed problem in lung cancer patients treated with concurrent chemoradiation
Presenter: Sharif Ahmed
Session: Poster display session
Resources:
Abstract
448P - Incidence and severity of chemotherapy induced peripheral neuropathy in geriatric population who are receiving chemotherapy
Presenter: Alekhya Mandepudi
Session: Poster display session
Resources:
Abstract
449P - Utility of screening tool for assessment of chemotherapy induced peripheral neuropathy in cancer patients
Presenter: PRUTHVI Paibhavi
Session: Poster display session
Resources:
Abstract
450P - Supportive care to control nausea and dizziness in malignant tumours: A systematic review
Presenter: Rainer Spiegel
Session: Poster display session
Resources:
Abstract
451P - The safety of ramucirumab without H1-antihistamines as a premedication in patients with solid cancers: A retrospective study
Presenter: Nobuhiro Hattori
Session: Poster display session
Resources:
Abstract
452P - Expression of erythropoietin receptor in patient with anemia related chemotherapy and its correlation with absolute reticulocyte count
Presenter: Irza Wahid
Session: Poster display session
Resources:
Abstract
453P - Body mass index did not correlate with short term overall survival in breast cancers
Presenter: Jungsun Lee
Session: Poster display session
Resources:
Abstract
454P - Predictors of severity and comparison of CTCAE V3.0 vs V4.3 in assessing chemotherapy induced extravasation injuries
Presenter: Sangana Reddy
Session: Poster display session
Resources:
Abstract
455P - Assessment of nutritional status and quality of life among cancer patients undergoing chemotherapy
Presenter: Sri Prathima
Session: Poster display session
Resources:
Abstract
456P - Use of gamma irradiated bone allografts in treatment of various bone tumours
Presenter: Anchal Mishra
Session: Poster display session
Resources:
Abstract