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- Title
Afatinib as First-line Treatment of Older Patients With EGFR Mutation-Positive Non-Small-Cell Lung Cancer: Subgroup Analyses of the LUX-Lung 3, LUX-Lung 6, and LUX-Lung 7 Trials.
- Authors
Wu, Yi-Long; Sequist, Lecia V; Tan, Eng-Huat; Geater, Sarayut L; Orlov, Sergey; Zhang, Li; Lee, Ki Hyeong; Tsai, Chun-Ming; Kato, Terufumi; Barrios, Carlos H; Schuler, Martin; Hirsh, Vera; Yamamoto, Nobuyuki; O'Byrne, Kenneth; Boyer, Michael; Mok, Tony; Peil, Barbara; Märten, Angela; Chih-Hsin Yang, James; Paz-Ares, Luis
- Abstract
<bold>Background: </bold>Afatinib is approved in the US, Europe, and several other regions for first-line treatment for epidermal growth factor receptor mutation-positive (EGFRm+) non-small-cell lung cancer (NSCLC).<bold>Patients and Methods: </bold>Treatment-naive patients with advanced EGFRm+ NSCLC were randomized to afatinib (40 mg/d) versus cisplatin/pemetrexed (LUX-Lung 3 [LL3]) or cisplatin/gemcitabine (LUX-Lung 6 [LL6]), or versus gefitinib (250 mg/d; LUX-Lung 7 [LL7]). We report subgroup analyses according to age, including 65 years or older versus younger than 65 years (preplanned; LL3/LL6) and additional cutoffs up to 75 years and older (exploratory; LL7). Progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were evaluated.<bold>Results: </bold>Among the 134 of 345 (39%) and 86 of 364 (24%) patients aged 65 years and older in LL3 and LL6, median PFS was improved with afatinib versus chemotherapy (LL3: hazard ratio [HR], 0.64 [95% confidence interval (CI), 0.39-1.03]; LL6: HR, 0.16 [95% CI, 0.07-0.39]). Afatinib significantly improved OS versus chemotherapy in elderly patients with Del19+ NSCLC in LL3 (HR, 0.39 [95% CI, 0.19-0.80]). Among the 40 of 319 patients (13%) aged 75 years or older in LL7, median PFS (HR, 0.69 [95% CI, 0.33-1.44]) favored afatinib, consistent with the overall population. Afatinib-associated AEs in older patients were consistent with the overall populations.<bold>Conclusions: </bold>Subgroup analyses of the LL3, LL6, and LL7 trials show that afatinib is an effective and tolerable treatment for patients with EGFRm+ NSCLC, independent of age.
- Subjects
ANTINEOPLASTIC agents; CISPLATIN; CELL receptors; COMPARATIVE studies; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; GENETIC mutation; RESEARCH; EVALUATION research; DEOXYCYTIDINE; THERAPEUTICS
- Publication
Clinical Lung Cancer, 2018, Vol 19, Issue 4, pe465
- ISSN
1525-7304
- Publication type
journal article
- DOI
10.1016/j.cllc.2018.03.009