Posted on June 15th, 2012 by
Initial treatment with the targeted drug afatinib prolongs progression-free survival in patients with EGFR-positive advanced lung cancer when compared with standard chemotherapy, according to the results of a study presented at the 2012 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Illinois.
Lung cancer remains the leading cause of cancer death in the United States. Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. One sub-type of NSCLC is a type of lung cancer that is driven by a mutation in the epidermal growth factor receptor (EGFR) pathway. Each year in the United States over 18,000 individuals are diagnosed with NSCLC that harbors EGFR mutations. This type of cancer is associated with non-smokers and individuals of Asian descent.
EGFR is a protein located on the surface of many cancer cells that is involved in cancer growth. By blocking the EGFR pathway, targeted therapies help inhibit cancer growth. Afatinib is an investigational, targeted therapy that blocks the EGFR pathway as well as the ErbB family of receptors that are associated with the EGFR pathway, including HER2 (ErbB2) and HER4 (ErbB4). Thus far, afatinib appears to block the EGFR pathway more thoroughly than other targeted therapies.
The study included 345 patients with advanced NSCLC who had EGFR mutations. The patients were randomized to receive afatinib or standard combination chemotherapy treatment. After a median follow-up of 8 months, afatinib delayed disease progression by more than 4 months over standard therapy—progression-free survival (PFS) was 11.1 months with afatinib, compared to 6.9 months with standard therapy.
Afatinib was particularly beneficial to the 308 patients who had one of two common types of EGFR mutations (deletion 19 or L858R) that account of approximately 90 percent of all EGFR mutations. These patients experienced almost double the PFS—13.6 months in the afatinib group and 6.9 months in the standard chemotherapy group.
Patients receiving afatinib experienced a better quality of life than those receiving standard chemotherapy—and were slower to experience worsening of lung cancer symptoms such as cough and shortness of breath.
Overall survival data from the study will be available in about two years. At this point, the researchers speculate that afitinib appears to more broadly and effectively block the EGFR pathway than other targeted therapies and they conclude that it is a clinically relevant first-line treatment option. The treatment may help patients live longer without disease progression. Furthermore, it is administered orally, which could translate to fewer doctor visits and better quality of life.
Yang JCH, Schuler MH, Yamamoto N, et al. LUX-lung 3: A randomized, open-label, phase III study of afatinib versus pemetrexed and cisplatin as first-line treatment for patients with advanced adenocarcinoma of the lung harboring EGFR-activating mutations. Presented at the 2012 annual meeting of the American Society of Clinical Oncology, June 1-5, 2012, Chicago, IL. Abstract LBA7500.
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