Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12885-018-5110-2
Title: Influence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases
Authors: Tan, Wan-Ling 
Ng, Quan Sing 
Lim, Cindy
Tan, Eng Huat 
Toh, Chee Keong
Ang, Mei-Kim 
Kanesvaran, Ravindran 
Jain, Amit 
Tan, Daniel SW 
Lim, Darren Wan-Teck 
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
EGFR mutation NSCLC
Metastatic
Afatinib
Brain metastases
Dose
CELL LUNG-CANCER
RECEPTOR GENE-MUTATIONS
INTERNATIONAL-ASSOCIATION
EFFICACY
ADENOCARCINOMA
GEFITINIB
ERLOTINIB
SAFETY
COMMON
Issue Date: 3-Dec-2018
Publisher: BMC
Citation: Tan, Wan-Ling, Ng, Quan Sing, Lim, Cindy, Tan, Eng Huat, Toh, Chee Keong, Ang, Mei-Kim, Kanesvaran, Ravindran, Jain, Amit, Tan, Daniel SW, Lim, Darren Wan-Teck (2018-12-03). Influence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases. BMC CANCER 18 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s12885-018-5110-2
Abstract: Background: Afatinib is an oral irreversible epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) indicated in first-line treatment of advanced EGFR-mutant (EGFRm+) non-small cell lung cancer (NSCLC). Dose dependent side effects can limit drug exposure, which may impact on extracranial and central nervous system (CNS) disease control. Methods: We performed a retrospective study of 125 patients diagnosed with advanced EGFRm+ NSCLC treated with first-line afatinib at a tertiary Asian cancer center, exploring clinicopathological factors that may influence survival outcomes. Median progression free survival (PFS) was estimated using the Kaplan-Meier method. Comparison of PFS between subgroups of patients was done using log-rank tests and Cox proportional hazards models. Results: Out of 125 patients, 62 (49.6%) started on 40 mg once daily (OD) afatinib, 61 (48.8%) on 30 mg OD and 1 (0.8%) on 20 mg OD. After median follow-up of 13.8 months from afatinib initiation, the observed response rate was 70.4% and median PFS 11.9 months (95% CI 10.3-19.3). 42 (33.6%) patients had baseline brain metastases (BM) and PFS of those who started on 40 mg OD (n = 17) vs. 30 mg OD (n = 25) was 13.3 months vs. 5.3 months (HR 0.39, 95% CI 0.15-0.99). BM+ patients who started on 40 mg had similar PFS to patients with no BM (13.3 months vs. 15.0 months; HR 0.79, 95% CI 0.34-1.80). Conclusion: In patients with advanced EGFRm+ NSCLC with BM+, initiating patients on afatinib 40 mg OD was associated with improved PFS compared to 30 mg OD, underscoring the potential importance of dose intensity in control of CNS disease.
Source Title: BMC CANCER
URI: https://scholarbank.nus.edu.sg/handle/10635/218617
ISSN: 14712407
DOI: 10.1186/s12885-018-5110-2
Appears in Collections:Staff Publications
Elements

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
Influence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases.pdf806.03 kBAdobe PDF

OPEN

PublishedView/Download

SCOPUSTM   
Citations

15
checked on Jan 26, 2023

Page view(s)

73
checked on Jan 26, 2023

Download(s)

1
checked on Jan 26, 2023

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.