Hisao Imai1, Kyoichi Kaira2, Kensuke Suzuki3, Masaki Anzai4, Takeshi Tsuda3, Tamotsu Ishizuka4, Tomohito Kuwako5, Ichiro Naruse6, Kenji Nemoto7, Junji Uchino8, Nobutoshi Morozumi9, Shinichi Ishihara10, Koichi Minato1, Takeshi Hisada11. 1. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ohta, Gunma, Japan. 2. Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. Electronic address: kkaira1970@yahoo.co.jp. 3. Division of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan. 4. Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan. 5. Division of Respirology, National Hospital Organization Shibukawa Medical Center Hospital, Shibukawa, Gunma, Japan. 6. Division of Respiratory Medicine, Hidaka Hospital, Takasaki, Gunma, Japan. 7. Division of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, Tokai, Ibaraki, Japan. 8. Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan. 9. Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan. 10. Division of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Gunma, Japan. 11. Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Abstract
OBJECTIVE: The efficacy and safety of afatinib in elderly patients with EGFR-mutated non-small-cell lung cancer (NSCLC) have not been evaluated. This study aimed to assess the efficacy and safety of afatinib in elderly chemotherapy-naive patients with NSCLC harboring sensitive EGFR mutations. MATERIALS AND METHODS: We prospectively assessed the clinical effects of afatinib as a first-line treatment for elderly (age ≥70 years) NSCLC patients with EGFR mutations (exon 19 deletion or exon 21 L858R mutation). All patients were initially administered afatinib (30 mg/day). RESULTS: Between May 2014 and August 2017, 40 patients (13 men, 27 women) with adenocarcinoma were included in our analysis. The median age was 77 years (range, 70-85 years). The dose was reduced in 19 patients. The objective overall response and disease control rates were 72.5% and 100%, respectively, and the median progression-free survival and overall survival were 12.9 months and not reached, respectively. Common adverse events (AEs) included diarrhea, rash/acne, and anemia. Major grade 3 or higher toxicities included diarrhea (12.5%), mucositis (7.5%), and pneumonitis (7.5%). Afatinib treatment was discontinued in 8 patients owing to AEs of elevated amylase (n = 1), liver dysfunction (n = 1), rash/acne (n = 1), nail change (n = 1), anorexia (n = 2), pneumonitis (n = 2), and diarrhea (n = 2). Two patients died due to treatment-related pneumonitis. CONCLUSIONS: This is the first study that verified the efficacy and feasibility of first-line chemotherapy with afatinib at 30 mg/day in elderly patients with advanced NSCLC harboring sensitive EGFR mutations. First-line afatinib of 30 mg/day could be a treatment option in this patient population.
OBJECTIVE: The efficacy and safety of afatinib in elderly patients with EGFR-mutated non-small-cell lung cancer (NSCLC) have not been evaluated. This study aimed to assess the efficacy and safety of afatinib in elderly chemotherapy-naive patients with NSCLC harboring sensitive EGFR mutations. MATERIALS AND METHODS: We prospectively assessed the clinical effects of afatinib as a first-line treatment for elderly (age ≥70 years) NSCLCpatients with EGFR mutations (exon 19 deletion or exon 21 L858R mutation). All patients were initially administered afatinib (30 mg/day). RESULTS: Between May 2014 and August 2017, 40 patients (13 men, 27 women) with adenocarcinoma were included in our analysis. The median age was 77 years (range, 70-85 years). The dose was reduced in 19 patients. The objective overall response and disease control rates were 72.5% and 100%, respectively, and the median progression-free survival and overall survival were 12.9 months and not reached, respectively. Common adverse events (AEs) included diarrhea, rash/acne, and anemia. Major grade 3 or higher toxicities included diarrhea (12.5%), mucositis (7.5%), and pneumonitis (7.5%). Afatinib treatment was discontinued in 8 patients owing to AEs of elevated amylase (n = 1), liver dysfunction (n = 1), rash/acne (n = 1), nail change (n = 1), anorexia (n = 2), pneumonitis (n = 2), and diarrhea (n = 2). Two patients died due to treatment-related pneumonitis. CONCLUSIONS: This is the first study that verified the efficacy and feasibility of first-line chemotherapy with afatinib at 30 mg/day in elderly patients with advanced NSCLC harboring sensitive EGFR mutations. First-line afatinib of 30 mg/day could be a treatment option in this patient population.
Authors: Tina Lamy; Bastien Cabarrou; David Planchard; Xavier Quantin; Sophie Schneider; Michael Bringuier; Benjamin Besse; Nicolas Girard; Christos Chouaid; Thomas Filleron; Gaëtane Simon; Capucine Baldini Journal: Cancers (Basel) Date: 2021-12-24 Impact factor: 6.639
Authors: Antonio Passaro; Filippo de Marinis; Hai-Yan Tu; Konstantin K Laktionov; Jifeng Feng; Artem Poltoratskiy; Jun Zhao; Eng Huat Tan; Maya Gottfried; Victor Lee; Dariusz Kowalski; Cheng Ta Yang; B J Srinivasa; Laura Clementi; Tejaswini Jalikop; Dennis Chin Lun Huang; Agnieszka Cseh; Keunchil Park; Yi-Long Wu Journal: Front Oncol Date: 2021-07-09 Impact factor: 6.244