Osimertinib versus afatinib in patients with T790M-positive, non-small-cell lung cancer and multiple central nervous system metastases after failure of initial EGFR-TKI treatment

BMC Pulmonary Medicine

Bin Liu¹  Wei Sun²  Lei Cao²  Qilong Liu³  Xiaowei Gu⁴  Guixing Xu⁵  Weiguang Yu⁶  Meiji Chen⁷  Fei Teng⁸  Huanyi Lin⁹  Yang Yang^1,10  Xiaoli Li^1,10  Na Xiao^1,10 

[1]Central Laboratory, Affiliated Hospital of Hebei University

[2]Department of Anaesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology

[3]Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University

[4]Department of Head and Neck Surgery, Affiliated Hospital of Hebei University

[5]Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-Sen University

[6]Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-Sen University

[7]Department of Pediatrics, The First Affiliated Hospital, Sun Yat-Sen University

[8]Department of Radiotherapy, Affiliated Hospital of Hebei University

[9]Department of Urinary Surgery, The First Affiliated Hospital, Sun Yat-Sen University

[10]Hebei Key Laboratory of Cancer Radiotherapy and Chemotherapy, Department of Medical Oncology, Affiliated Hospital of Hebei University

关键词: Osimertinib;    Afatinib;    Non-small-cell lung cancer;    Central nervous system;    Metastases;    Survival;   

DOI  :  10.1186/s12890-021-01539-x

来源: DOAJ

【 摘 要 】

Abstract Background The purpose of this study was to compare the efficacy of osimertinib (OSI) versus afatinib (AFA) in patients with T790M-positive, non-small-cell lung cancer (NSCLC) and multiple central nervous system (CNS) metastases after failure of initial epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment. Methods Consecutive patients with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment were retrospectively identified from our medical institution during 2016–2018 and underwent either oral 80 daily OSI or oral 40 daily AFA every 3 weeks for up to 6 cycles, until disease progression, intolerable adverse events (AEs), or death. The co-primary endpoints were overall survival (OS) and progression-free survival (PFS). Results The cohort consisted of 124 patients (OSI: n = 60, mean age = 64.24 years [SD: 12.33]; AFA: n = 64, mean age = 64.13 years [SD: 13.72]). After a median follow-up of 24 months (range, 3 to 28), a significant improvement in OS was detected (hazard ratio [HR] 0.59, 95% confidence interval [CI], 0.39–0.91; p = 0.0160; median, 13.7 months [95% CI, 11.1–14.8] for OSI vs 9.6 months [95% CI, 8.4–10.2] for AFA). The median duration of PFS was significantly longer with OSI than with AFA (HR 0.62; 95% CI, 0.41–0.91; p = 0.014; median, 4.5 months [95% CI, 3.5–5.7] vs 3.9 months [95% CI, 3.1–4.8]). The proportion of grade 3 or higher adverse events (AEs) was lower with OSI (22.4%) than with AFA (39.4%). Conclusions In patients with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment, OSI may be associated with significantly improved survival benefit compared with AFA, with a controllable tolerability profile.

【 授权许可】

Unknown