A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer
Abstract Background Recent reports suggested combining ramucirumab with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) to overcome EGFR resistance in non–small cell lung cancer (NSCLC). Nonetheless, evidence supporting the activity of afatinib and ramucirumab is lacking. T...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-023-10909-z |
| _version_ | 1827948056858853376 |
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| author | Chun-Yao Huang Hui-Li Huang Chou-Chin Lan Yi-Chih Huang Yao-Kuang Wu |
| author_facet | Chun-Yao Huang Hui-Li Huang Chou-Chin Lan Yi-Chih Huang Yao-Kuang Wu |
| author_sort | Chun-Yao Huang |
| collection | DOAJ |
| description | Abstract Background Recent reports suggested combining ramucirumab with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) to overcome EGFR resistance in non–small cell lung cancer (NSCLC). Nonetheless, evidence supporting the activity of afatinib and ramucirumab is lacking. This study investigated the survival benefits and safety profile of afatinib plus ramucirumab in patients with treatment-naïve, EGFR-mutated, metastatic NSCLC. Materials and methods The medical records of patients with EGFR-mutated NSCLC were retrospectively retrieved. Patients who received first-line sequential afatinib followed by ramucirumab and the first-line combination of afatinib plus ramucirumab were included. The Kaplan-Meier was used to estimate the progression-free survival (PFS) of all included patients, patients on sequential afatinib followed by ramucirumab (PFS1), and patients on the up-front combination of afatinib and ramucirumab (PFS2). Results Thirty-three patients were included (25 women; median age: 63 [45–82] years). The median follow-up of the included patients was 17 months (range 6–89 months). the median PFS for the whole cohort was 71 months (95% CI 67.2–74.8) with eight events during the follow-up. The median PFS1 and PFS2 were 71 months (95 CI not defined) and 26 months (95% CI 18.6–33.4), respectively. In terms of OS, the median OS for all patients and patients on sequential treatment was not defined, while the median OS for patients on upfront combination was 30 months (95% CI 20.9–39.1). There was no significant association between EGFR mutation type and PFS1 or PFS2. Conclusions Afatinib plus ramucirumab could improve the PFS of patients with EGFR-positive NSCLC at a predictable safety profile. Our data also suggest a survival benefit of adding ramucirumab to afatinib in patients with uncommon mutations, which should be investigated further. |
| first_indexed | 2024-04-09T12:49:26Z |
| format | Article |
| id | doaj.art-6b61427789c34abfb196a15e72b20057 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-09T12:49:26Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-6b61427789c34abfb196a15e72b200572023-05-14T11:19:48ZengBMCBMC Cancer1471-24072023-05-012311810.1186/s12885-023-10909-zA real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancerChun-Yao Huang0Hui-Li Huang1Chou-Chin Lan2Yi-Chih Huang3Yao-Kuang Wu4Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationAbstract Background Recent reports suggested combining ramucirumab with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) to overcome EGFR resistance in non–small cell lung cancer (NSCLC). Nonetheless, evidence supporting the activity of afatinib and ramucirumab is lacking. This study investigated the survival benefits and safety profile of afatinib plus ramucirumab in patients with treatment-naïve, EGFR-mutated, metastatic NSCLC. Materials and methods The medical records of patients with EGFR-mutated NSCLC were retrospectively retrieved. Patients who received first-line sequential afatinib followed by ramucirumab and the first-line combination of afatinib plus ramucirumab were included. The Kaplan-Meier was used to estimate the progression-free survival (PFS) of all included patients, patients on sequential afatinib followed by ramucirumab (PFS1), and patients on the up-front combination of afatinib and ramucirumab (PFS2). Results Thirty-three patients were included (25 women; median age: 63 [45–82] years). The median follow-up of the included patients was 17 months (range 6–89 months). the median PFS for the whole cohort was 71 months (95% CI 67.2–74.8) with eight events during the follow-up. The median PFS1 and PFS2 were 71 months (95 CI not defined) and 26 months (95% CI 18.6–33.4), respectively. In terms of OS, the median OS for all patients and patients on sequential treatment was not defined, while the median OS for patients on upfront combination was 30 months (95% CI 20.9–39.1). There was no significant association between EGFR mutation type and PFS1 or PFS2. Conclusions Afatinib plus ramucirumab could improve the PFS of patients with EGFR-positive NSCLC at a predictable safety profile. Our data also suggest a survival benefit of adding ramucirumab to afatinib in patients with uncommon mutations, which should be investigated further.https://doi.org/10.1186/s12885-023-10909-zAfatinibRamucirumabNon–small cell lung cancerEFGR mutation |
| spellingShingle | Chun-Yao Huang Hui-Li Huang Chou-Chin Lan Yi-Chih Huang Yao-Kuang Wu A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer BMC Cancer Afatinib Ramucirumab Non–small cell lung cancer EFGR mutation |
| title | A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer |
| title_full | A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer |
| title_fullStr | A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer |
| title_full_unstemmed | A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer |
| title_short | A real-world study of Afatinib plus ramucirumab in treatment-naïve, EGFR-mutated, non–small cell lung cancer |
| title_sort | real world study of afatinib plus ramucirumab in treatment naive egfr mutated non small cell lung cancer |
| topic | Afatinib Ramucirumab Non–small cell lung cancer EFGR mutation |
| url | https://doi.org/10.1186/s12885-023-10909-z |
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