Abstract 578P
Background
This study aimed to describe efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for elderly patients (≥65 years) with treatment-naïve EGFR-mutated advanced non-small cell lung cancer (NSCLC).
Methods
Patients with treatment-naïve EGFR-mutated advanced NSCLC were enrolled at several hospitals in Taiwan between May 2014 and January 2018. Patient characteristics, including age, sex, performance status (PS), smoking history, tumor morphology, mutation type, stage, metastasis, efficacy and safety of EGFR-TKIs were compared. Univariate and multivariate analyses were performed to explore possible prognostic factors.
Results
This study enrolled 1,343 patients with treatment-naïve EGFR-mutated advanced NSCLC, of which 554 were aged <65 years, 383 were aged 65–74 years, 323 were aged 75–84 years, and 83 were aged ≥85 years. In elderly patients, afatinib showed significantly better efficacy, with a median progression-free survival (PFS) of 14.7 months and overall survival (OS) of 22.2 months, than gefitinib (9.9 months and 17.7 months, respectively) and erlotinib (10.8 months and 18.5 months, respectively; PFS: p=0.003; OS: p=0.026). However, patients treated with afatinib also experienced more grade ≥3 adverse events than those treated with gefitinib and erlotinib, including skin toxicities (6.1% vs. 1.8% vs. 3.9%, p=0.052), paronychia (5.1% vs. 0.5% vs. 2.3%, p=0.006), mucositis (1.9% vs. 0% vs. 1.1%, p=0.122), and diarrhea (9.3% vs. 2.3% vs. 1.5%, p<0.0001). PS of 2-4, stage IV disease, liver, bone, pleura, adrenal, and pericardial metastases, and EGFR-TKI treatment with gefitinib were associated with poor PFS, while age of ≥ 85 years, PS of 2-4, stage IV disease, liver, brain, bone, pleura, adrenal, and pericardial metastases, and EGFR-TKI treatment with gefitinib were associated with poor OS. These factors were independent prognostic factors for both PFS and OS.
Conclusions
For elderly patients with EGFR-mutated advanced NSCLC, afatinib was associated with better efficacy than gefitinib or erlotinib in elderly patients with EGFR-mutated advanced NSCLC as a first-line treatment with acceptable AEs.
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
143P - Ablation combined with tislelizumab in treating hepatocellular carcinoma: A phase II trial
Presenter: Yangxun Pan
Session: Poster Display
Resources:
Abstract
144P - Integrated clinical and genomic models using machine-learning methods to predict the efficacy of paclitaxel-based chemotherapy in patients with advanced gastric cancer from K-MASTER project
Presenter: Jwa Hoon Kim
Session: Poster Display
Resources:
Abstract
145P - Tislelizumab (TIS) + chemotherapy (Chemo)/chemoradiotherapy (CRT) as neoadjuvant treatment for resectable esophageal squamous cell carcinoma (R-ESCC)
Presenter: Longqi Chen
Session: Poster Display
Resources:
Abstract
146P - Phase (ph) Ib results of bemarituzumab (BEMA) added to capecitabine/oxaliplatin (CAPOX) or S-1/oxaliplatin (SOX) with or without nivolumab (NIVO) for previously untreated advanced gastric/gastroesophageal junction cancer (G/GEJC): FORTITUDE-103 study
Presenter: Keun-Wook Lee
Session: Poster Display
Resources:
Abstract
147P - Four-year overall survival (OS) update from the phase III HIMALAYA study of tremelimumab plus durvalumab in unresectable hepatocellular carcinoma (uHCC)
Presenter: Stephen Chan
Session: Poster Display
Resources:
Abstract
148P - Safety and efficacy of atezolizumab (Atezo) + bevacizumab (Bev) in Japanese patients (pts) with unresectable hepatocellular carcinoma (uHCC): Preliminary analysis of a prospective, multicenter, observational study (ELIXIR)
Presenter: Teiji Kuzuya
Session: Poster Display
Resources:
Abstract
149P - A prospective observational study of MSI screening in unresectable chemotherapy-naïve advanced gastric cancer/gastroesophageal junction cancer: WJOG13320GPS
Presenter: Yukiya Narita
Session: Poster Display
Resources:
Abstract
150P - Anlotinib plus chemotherapy as first-line therapy for gastrointestinal tumor patients with unresectable liver metastasis: Updated results from a multi-cohort, multi-center phase II trial ALTER-G-001-cohort C
Presenter: Junwei Wu
Session: Poster Display
Resources:
Abstract
151P - Relationship between depth of response and early tumor shrinkage with overall survival in advanced pancreatic cancer
Presenter: EMIKA KUROKI
Session: Poster Display
Resources:
Abstract
152P - Interim analysis of the NAPOLEON-2 study: Safety evaluation of nanoliposomal irinotecan with fluorouracil and folinic acid for unresectable pancreatic cancer patients with prior biliary drainage
Presenter: Futa Koga
Session: Poster Display
Resources:
Abstract