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Totality outcome of afatinib sequential treatment in patients with EGFR mutation-positive non-small cell lung cancer in South Korea (TOAST): Korean Cancer Study Group (KCSG) LU-19-22

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Author(s)
Hyun Ae JungMin Hee HongHyun Woo LeeKyung Hee LeeIl Hwan KimYoung Joo MinHee Kyung AhnByoung Yong ShimYoon Hee ChoiYun-Gyoo LeeJeong A KimJoung Soon JangSeong-Hoon ShinKeon Uk ParkJin Hyoung KangKeunchil Park
Keimyung Author(s)
Park, Keon Uk
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transl Lung Cancer Res
Issued Date
2022
Volume
11
Issue
7
Keyword
Non-small cell lung cancer (NSCLC)epidermal growth factor receptor (EGFR)tyrosine kinase inhibitor (TKI)afatinibsequential treatment
Abstract
Background:
Irrespective of the first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor chosen, acquired resistance to therapy is inevitable. Therefore, a key consideration when assessing therapeutic choices is the availability of subsequent treatment options following disease progression. We assessed clinical outcomes in patients who received first-line afatinib treatment with various second-line treatments including osimertinib for patients acquiring the T790M mutation.

Methods:
A total of 737 EGFR mutation-positive (EGFR M+) non-small cell lung cancer (NSCLC) patients receiving first-line afatinib treatment were categorized by second-line treatment: T790M+ sequentially treated with osimertinib (cohort A, n=116); T790M− given chemotherapy or others (cohort B, n=143); patients with unknown T790M status (cohort C, n=111); and patients who were undergoing afatinib treatment at the time of data collection, were dead, had discontinued afatinib treatment due to serious adverse events or were lost to follow-up (cohort D, n=367). The primary outcomes were total time on treatment (TOT) and TOT for first-line (TOT-1) and second-line treatments (TOT-2). Secondary outcomes were objective response rates (ORR), overall survival (OS), and central nervous system (CNS) efficacy.

Results:
Median total TOT in cohorts A, B, C, and D were 35.10 months [95% confidence interval (CI): 30.09–43.53 months], 18.80 months (95% CI: 16.92–20.20 months), 12.00 months (95% CI: 10.22–14.98 months), and 42.60 months (95% CI: 30.95–59.23 months), respectively. The ORR of patients given afatinib was 75.7%. In patients with initial brain metastasis without local treatment, the CNS response rate was 67.0% and CNS progression-free survival was 24.70 months (95% CI: 19.84–33.15 months).

Conclusions:
This study showed that sequential approach of afatinib followed by second line treatment is an effective therapeutic strategy for EGFR M+ NSCLC patients.
Keimyung Author(s)(Kor)
박건욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2226-4477
Source
https://tlcr.amegroups.com/article/view/65436/html
DOI
10.21037/tlcr-22-79
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44408
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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