Lower Dose of First-Line Afatinib Treatment in Patients with EGFR Mutation-Positive Advanced Lung Adenocarcinoma: Real-World Data from a Tertiary Hospital in Taiwan

Wei-Cheng Hong；Min-Hsi Lin；Chiu-Fan Chen；Kuo-An Chu；Chun-Hsiang Hsu

Lower-dose afatinib ； lung adenocarcinoma ； time-on-treatment ； overall survival

胸腔醫學

39卷3期（2024 / 09 / 01）

208 - 218

英文

Introduction: Afatinib has favorable response rates and progression-free survival in lung cancer patients with epidermal growth factor receptor (EGFR) mutations. However, dose reduction is common due to severe side effects. Methods: We enrolled patients with EGFR mutation-positive advanced lung adenocarcinoma from 1 January 2015 to 31 December 2019, and retrospectively analyzed the efficacy of low-dose (LD) and standard-dose (SD) afatinib treatment. Patients initially started with either 30 mg or 40 mg; those that used 40 mg daily as a final dose were included in the SD group, while those using less than 40 mg daily were in the LD group. The patients received first-line afatinib until the occurrence of disease progression, death, or intolerable adverse events. The primary outcome was time-on-treatment (ToT) and overall survival (OS). Results: A total of 129 lung cancer patients were enrolled and received afatinib treatment. Of these, 82 (63.6%) were on LD afatinib, and 47 (36.4%) were on SD afatinib. Patients who received LD afatinib treatment tended to be older (48% vs. 28%), were more likely to be female (61% vs. 26%), and had a low BMI (26% vs. 6.4%). The median ToT was 17.9 months in the LD group and 12.7 months in the SD group (HR: 1.28; 95% confidence interval (CI): 0.86-1.91, p =0.218). Median OS was 29.5 months in the LD group and 24.6 months in the SD group (HR: 1.21; 95% CI: 0.79-1.85, p =0.372). Conclusion: The ToT and OS of LD afatinib patients was similar to that of SD afatinib patients.