Real-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) study.

Humans Carcinoma, Non-Small-Cell Lung / drug therapy Erlotinib Hydrochloride / therapeutic use Afatinib / therapeutic use Retrospective Studies Lung Neoplasms / drug therapy Gefitinib / pharmacology Protein Kinase Inhibitors / therapeutic use Quinazolines / therapeutic use ErbB Receptors / genetics Mutation Exons

Afatinib Erlotinib Exon 18 Exon 20 NSCLC

Journal

Journal of cancer research and clinical oncology

ISSN: 1432-1335

Titre abrégé: J Cancer Res Clin Oncol

Pays: Germany

ID NLM: 7902060

Informations de publication

Date de publication:
Feb 2023

Historique:

received: 30 11 2021

accepted: 11 03 2022

pubmed: 7 4 2022

medline: 18 2 2023

entrez: 6 4 2022

Statut: ppublish

Résumé

To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options.

Identifiants

DOI: 10.1007/s00432-022-03984-5 PMID: 35381885

pubmed: 35381885

doi: 10.1007/s00432-022-03984-5

pii: 10.1007/s00432-022-03984-5

doi:

Substances chimiques

Erlotinib Hydrochloride DA87705X9K

Afatinib 41UD74L59M

Gefitinib S65743JHBS

Protein Kinase Inhibitors 0

Quinazolines 0

ErbB Receptors EC 2.7.10.1

EGFR protein, human EC 2.7.10.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

865-875

Informations de copyright

Références

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