310P - Clinical characteristics and real-world progression-free survival of patients with EGFR mutation positive non-small cell lung cancer treated with afatinib as first-line: A retrospective cohort study from Indonesia

Background

The epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) afatinib, demonstrated superiority to chemotherapy as a first-line treatment and improved survival in non-small cell lung cancer (NSCLC) patients with EGFR mutations. This study aimed to investigate the clinical risk factors affecting progression-free survival (PFS) of patients treated with first-line afatinib in Indonesia.

Methods

This is a retrospective cohort study. Clinical characteristics and data were collected from medical records from 14 respiratory service centers nationwide between January 2017 and December 2021. The Kaplan-Meier method and log-rank test were used to estimate PFS, and the Cox proportional hazards model was used for multivariate analyses.

Results

A total 106 patients treated with first-line afatinib were enrolled. The median age was 59 years (range: 18-81) and 54.3% were female. Patients with smoking history were 34.3% while 22.9% were with ECOG performance status (PS) ≥2 and 98.1% with EGFR common mutations. Median PFS was 12 months (95% CI: 10.5-13.5). Patients with exon 19 deletion, never smoker, and ECOG PS 1 had the longest PFS of 13 months, and those with poor ECOG PS were with the shortest PFS of 8 months. Multivariate analysis revealed that poor ECOG PS and smoking history significantly affected PFS (p < 0.001 and p < 0.050, respectively). Other demographic characteristics had no impact in PFS including gender, race, history of family cancer, history of tuberculosis, staging, pleural effusion, brain metastasis, and EGFR mutations.

Conclusions

This retrospective cohort study showed that smoking history and poor ECOG PS are independent factors associated with poor PFS in EGFR mutation positive NSCLC with first-line afatinib treatment.

Clinical trial identification

Editorial acknowledgement

This research is supported by the Indonesia Association for the Study of Thoracic Oncology (IASTO) as well as Boehringer Ingelheim with an editorial support.

Legal entity responsible for the study

Indonesian Association for the Study of Thoracic Oncology (IASTO).

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.