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Open Access 01-12-2021 | Tyrosine Kinase Inhibitors | Research article

Lower starting dose of afatinib for the treatment of metastatic lung adenocarcinoma harboring exon 21 and exon 19 mutations

Authors: Yi-Chieh Chen, Ming-Ju Tsai, Mei-Hsuan Lee, Chia-Yu Kuo, Mei-Chiou Shen, Ying-Ming Tsai, Huang-Chi Chen, Jen-Yu Hung, Ming-Shyan Huang, Inn-Wen Chong, Chih-Jen Yang

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Afatinib has shown favorable response rates (RRs) and longer progression free survival (PFS) in lung cancer patients harboring EGFR mutations compared with standard platinum-based chemotherapy. However, serious adverse drug reactions (ADRs) limit the clinical application of afatinib.

Methods

We designed a retrospective study, enrolling all patients with metastatic lung adenocarcinoma who were diagnosed and treated with 30 or 40 mg daily afatinib as their initial treatment in three Kaohsiung Medical University-affiliated hospitals in Taiwan.

Results

A total of 179 patients were enrolled in the study, of which 102 (57%) and 77 (43%) received 30 mg and 40 mg afatinib daily as their initial treatment, respectively. The patients initially using 30 mg afatinib daily had a similar RR (75% vs. 83%, p = 0.1672), median PFS (14.5 vs. 14.8 months, log-rank p = 0.4649), and median OS (34.0 vs. 25.2 months, log-rank p = 0.5982) compared with those initially using 40 mg afatinib daily. Patients initially receiving 30 mg afatinib daily had fewer ADRs compared with those using 40 mg daily. The overall incidence of moderate and severe ADRs was significantly lower in patients receiving 30 mg afatinib daily compared with those using 40 mg daily (49% vs. 77%, p = 0.002); similar findings was observed in terms of severe ADRs (7% vs. 24%, p < 0.0001).

Conclusion

Patients receiving 30 mg afatinib daily as their initial treatment had similar RR, PFS, OS, but significantly fewer serious ADRs, as compared with those using 40 mg as their starting dose.

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Title: Lower starting dose of afatinib for the treatment of metastatic lung adenocarcinoma harboring exon 21 and exon 19 mutations
Authors: Yi-Chieh Chen
Ming-Ju Tsai
Mei-Hsuan Lee
Chia-Yu Kuo
Mei-Chiou Shen
Ying-Ming Tsai
Huang-Chi Chen
Jen-Yu Hung
Ming-Shyan Huang
Inn-Wen Chong
Chih-Jen Yang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Tyrosine Kinase Inhibitors
Tyrosine Kinase Inhibitors
Afatinib
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08235-3

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Abstract

Background

Methods

Results

Conclusion

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