Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12885-018-5110-2
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dc.titleInfluence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases
dc.contributor.authorTan, Wan-Ling
dc.contributor.authorNg, Quan Sing
dc.contributor.authorLim, Cindy
dc.contributor.authorTan, Eng Huat
dc.contributor.authorToh, Chee Keong
dc.contributor.authorAng, Mei-Kim
dc.contributor.authorKanesvaran, Ravindran
dc.contributor.authorJain, Amit
dc.contributor.authorTan, Daniel SW
dc.contributor.authorLim, Darren Wan-Teck
dc.date.accessioned2022-04-07T08:39:27Z
dc.date.available2022-04-07T08:39:27Z
dc.date.issued2018-12-03
dc.identifier.citationTan, 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
dc.identifier.issn14712407
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/218617
dc.description.abstractBackground: 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.
dc.language.isoen
dc.publisherBMC
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectOncology
dc.subjectEGFR mutation NSCLC
dc.subjectMetastatic
dc.subjectAfatinib
dc.subjectBrain metastases
dc.subjectDose
dc.subjectCELL LUNG-CANCER
dc.subjectRECEPTOR GENE-MUTATIONS
dc.subjectINTERNATIONAL-ASSOCIATION
dc.subjectEFFICACY
dc.subjectADENOCARCINOMA
dc.subjectGEFITINIB
dc.subjectERLOTINIB
dc.subjectSAFETY
dc.subjectCOMMON
dc.typeArticle
dc.date.updated2022-04-07T02:40:13Z
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1186/s12885-018-5110-2
dc.description.sourcetitleBMC CANCER
dc.description.volume18
dc.description.issue1
dc.published.statePublished
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