The Effectiveness of Afatinib as First-Line Treatment in Vietnamese Patients With EGFR-Mutant Non-Small Cell Lung Cancer and Brain Metastases

被引:0
作者
Van Pham, Thai [1 ,2 ]
Vu, Thanh Ha [1 ,3 ]
Nguyen, Hoa Thai Thi [3 ]
Pham, Phuong Cam [2 ]
Do, Anh Tu [3 ]
Nguyen, Tuan Khoi [4 ]
Hoang, Thi Anh Thu [4 ]
Le, Tuan Anh [5 ]
Vuong, Dinh Thy Hao [5 ]
Nguyen, Dac Nhan Tam [6 ]
Dang, Van Khiem [7 ]
Nguyen, Thi Oanh [7 ]
Pham, Van Luan [8 ]
Nguyen, Minh Hai [8 ]
Vo, Thi Huyen Trang [2 ]
Mai, Khoa Trong [2 ]
Do, Hung Kien [3 ]
Nguyen, Thi Thuy Hang [3 ]
Trinh, Le Huy [1 ]
Nguyen, Hoang Gia [9 ]
Truong, Cong Minh [3 ]
Pham, Tran Minh Chau [4 ]
机构
[1] Hanoi Med Univ, Dept Oncol, Hanoi, Vietnam
[2] Bach Mai Hosp, Nucl Med & Oncol Ctr, Hanoi, Vietnam
[3] Vietnam Natl Canc Hosp, Dept Med Oncol, Hanoi, Vietnam
[4] Ho Chi Minh City Oncol Hosp, Dept Med Oncol, Ho Chi Minh, Vietnam
[5] Cho Ray Hosp, Oncol Ctr, Ho Chi Minh, Vietnam
[6] Thong Nhat Hosp, Dept Oncol, Ho Chi Minh, Vietnam
[7] Natl Lung Hosp, Dept Oncol, Hanoi, Vietnam
[8] 108 Mil Cent Hosp, Dept Resp Med, Hanoi, Vietnam
[9] Hanoi Oncol Hosp, Dept Med Oncol, Hanoi, Vietnam
关键词
afatinib; brain metastases; EGFR mutations; first-line; non-small cell lung cancer; REAL-WORLD; ADENOCARCINOMA; CHEMOTHERAPY; MUTATIONS; SURVIVAL;
D O I
10.1111/ajco.14147
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
IntroductionThe role of afatinib in the first-line treatment of EGFR-mutant advanced non-small cell lung cancer (NSCLC) patients has been proven through clinical trials and real-world studies. However, additional data on the effectiveness of afatinib in patients with brain metastases are lacking.MethodsEGFR-mutant NSCLC patients with brain metastases were retrospectively reviewed across nine cancer centers in Vietnam from April 1, 2018 to June 1, 2022. The primary endpoints included central nervous system progression-free survival (CNS-PFS) and overall survival (OS). The secondary endpoints were the objective response rate (ORR) and CNS-ORR.ResultsAmong 87 enrolled patients, 21.8%, 17.2%, and 60.9% received whole-brain radiation, gamma knife, and no locoregional therapy, respectively. With a median follow-up of 32.2 months for CNS-PFS and 35.3 months for OS, the median CNS-PFS and OS were 17.9 and 29.9 months, respectively. In multivariate analysis, patients receiving whole-brain radiation had significantly shorter CNS-PFS than those untreated with local therapy (16.1 vs. 22.6 months, p = 0.019), but not translating to an inferior OS. Furthermore, both the CNS-PFS and OS of patients with uncommon mutations were significantly worse than those of patients with Del19 (11.3 vs. 24.2 months, p = 0.013 and 17.7 vs. 34.0 months, p = 0.003, respectively). Univariate and multivariate analyses showed that a lower afatinib starting dose did not significantly affect CNS-PFS or OS. The CNS-ORR and ORR were 77.4% and 71.3%, respectively.ConclusionIn our real-world study, afatinib showed encouraging effectiveness in Vietnamese patients with EGFR-mutant NSCLC and brain metastases at baseline.
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页码:281 / 289
页数:9
相关论文
共 30 条
[1]   Brain metastases [J].
Achrol, Achal Singh ;
Rennert, Robert C. ;
Anders, Carey ;
Soffietti, Riccardo ;
Ahluwalia, Manmeet S. ;
Nayak, Lakshmi ;
Peters, Solange ;
Arvold, Nils D. ;
Harsh, Griffith R. ;
Steeg, Patricia S. ;
Chang, Steven D. .
NATURE REVIEWS DISEASE PRIMERS, 2019, 5 (1)
[2]   Actionable Mutation Profiles of Non-Small Cell Lung Cancer patients from Vietnamese population [J].
Anh-Thu Huynh Dang ;
Vu-Uyen Tran ;
Thanh-Truong Tran ;
Hong-Anh Thi Pham ;
Dinh-Thong Le ;
Lam Nguyen ;
Ngoc-Vu Nguyen ;
Thai-Hoa Thi Nguyen ;
Chu Van Nguyen ;
Ha Thu Le ;
Mai-Lan Thi Nguyen ;
Vu Thuong Le ;
Phuc Huu Nguyen ;
Binh Thanh Vo ;
Hong-Thuy Thi Dao ;
Luan Thanh Nguyen ;
Thien-Chi Van Nguyen ;
Quynh-Tram Nguyen Bui ;
Long Hung Nguyen ;
Nguyen Huu Nguyen ;
Quynh-Tho Thi Nguyen ;
Truong Xuan Le ;
Thanh-Thuy Thi ;
Kiet Truong Dinh ;
Han Ngoc Do ;
Minh-Duy Phan ;
Hoai-Nghia Nguyen ;
Le Son Tran ;
Giang, Hoa .
SCIENTIFIC REPORTS, 2020, 10 (01)
[3]   Management of Brain Metastases in Non-Small-Cell Lung Cancer [J].
Ernani, Vinicius ;
Stinchcombe, Thomas E. .
JOURNAL OF ONCOLOGY PRACTICE, 2019, 15 (11) :563-+
[4]   Neurocognitive functioning and health-related quality of life in patients treated with stereotactic radiotherapy for brain metastases: a prospective study [J].
Habets, Esther J. J. ;
Dirven, Linda ;
Wiggenraad, Ruud G. ;
Verbeek-de Kanter, Antoinette ;
Nijeholt, Geert J. Lycklama a ;
Zwinkels, Hanneke ;
Klein, Martin ;
Taphoorn, Martin J. B. .
NEURO-ONCOLOGY, 2016, 18 (03) :435-444
[5]   Impact of afatinib dose modification on safety and effectiveness in patients with EGFR mutation-positive advanced NSCLC: Results from a global real-world study (RealGiDo) [J].
Halmos, Balazs ;
Tan, Eng-Huat ;
Soo, Ross A. ;
Cadranel, Jacques ;
Lee, Min Ki ;
Foucher, Pascal ;
Hsia, Te-Chun ;
Hochmair, Maximilian ;
Griesinger, Frank ;
Hida, Toyoaki ;
Kim, Edward ;
Melosky, Barbara ;
Maerten, Angela ;
Carcereny, Enric .
LUNG CANCER, 2019, 127 :103-111
[6]   The different central nervous system efficacy among gefitinib, erlotinib and afatinib in patients with epidermal growth factor receptor mutation-positive non-small cell lung cancer [J].
Jung, Hyun Ae ;
Woo, Sook Young ;
Lee, Se-Hoon ;
Ahn, Jin Seok ;
Ahn, Myung-Ju ;
Park, Keunchil ;
Sun, Jong-Mu .
TRANSLATIONAL LUNG CANCER RESEARCH, 2020, 9 (05) :1749-+
[7]   CNS efficacy of afatinib as first-line treatment in advanced non-small cell lung cancer patients with EGFR mutations [J].
Kang, Liping ;
Mai, Jianliang ;
Liang, Weiting ;
Zou, Qihua ;
Huang, Caiwen ;
Lin, Yongbin ;
Liang, Ying .
FRONTIERS IN ONCOLOGY, 2023, 13
[8]   Real-world analysis of first-line afatinib in patients with EGFR-mutant non-small cell lung cancer and brain metastasis: survival and prognostic factors [J].
Kim, Jehun ;
Jang, Tae Won ;
Choi, Chang Min ;
Kim, Mi Hyun ;
Lee, Sung Yong ;
Park, Cheol Kyu ;
Chang, Yoon Soo ;
Lee, Kye Young ;
Kim, Seung Joon ;
Yang, Sei Hoon ;
Ryu, Jeong Seon ;
Lee, Jeong Eun ;
Lee, Shin Yup ;
Park, Chan Kwon ;
Lee, Sang Hoon ;
Jang, Seung Hun ;
Yoon, Seong Hoon .
TRANSLATIONAL LUNG CANCER RESEARCH, 2023, 12 (06) :1197-+
[9]   Treatment effectiveness and tolerability of afatinib at different doses in patients with EGFR-mutated lung adenocarcinoma: How low can we go? [J].
Lim, Chor-Kuan ;
Wei, Yu-Feng ;
Tsai, Mao-Song ;
Chen, Kuan-Yu ;
Shih, Jin-Yuan ;
Yu, Chong-Jen .
EUROPEAN JOURNAL OF CANCER, 2018, 103 :32-40
[10]   Risk factors of brain metastasis during the course of EGFR-TKIs therapy for patients with EGFR-mutated advanced lung adenocarcinoma [J].
Ma, Xiaoyan ;
Zhu, Hui ;
Guo, Hongbo ;
Han, Anqin ;
Wang, Haiyong ;
Jing, Wang ;
Zhang, Yan ;
Kong, Li ;
Yu, Jinming .
ONCOTARGET, 2016, 7 (49) :81906-81917