Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients
Abstract Background Limited treatment options exist for relapsed advanced lung squamous cell carcinoma (SCC), leading to poor outcomes compared with adenocarcinoma. This study aimed to investigate the efficacy of second-line afatinib versus chemotherapy in patients with advanced lung SCC who progres...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-021-08920-3 |
| _version_ | 1818932699210973184 |
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| author | You-Yi Chen Shih-Chieh Chang Cheng-Yu Chang Chun-Fu Chang Yi-Chun Lai Yu-Feng Wei Chung-Yu Chen |
| author_facet | You-Yi Chen Shih-Chieh Chang Cheng-Yu Chang Chun-Fu Chang Yi-Chun Lai Yu-Feng Wei Chung-Yu Chen |
| author_sort | You-Yi Chen |
| collection | DOAJ |
| description | Abstract Background Limited treatment options exist for relapsed advanced lung squamous cell carcinoma (SCC), leading to poor outcomes compared with adenocarcinoma. This study aimed to investigate the efficacy of second-line afatinib versus chemotherapy in patients with advanced lung SCC who progressed after first-line chemotherapy. Methods In this retrospective, multisite cohort study, we recruited patients with initial locally advanced or metastatic lung SCC from four institutes in Taiwan between June 2014 and October 2020. The primary endpoint of this study was progression-free survival (PFS), and the secondary endpoints were the objective response rate (ORR), disease control rate (DCR), and overall survival (OS). Results The present study enrolled 108 patients: 19 received second-line afatinib, and 89 received second-line chemotherapy. The median ages were 71 and 67 years, respectively. PFS was significantly longer among patients who received afatinib than among those who received chemotherapy (median 4.7 months [95% confidence interval (CI), 0.1–7.5] vs. 2.6 months [95% CI, 0.9–6.7]; hazard ratio (HR) 0.53 [95% CI 0.32–0.88], p = 0.013). Compared with the chemotherapy group, OS was longer in the afatinib group but did not reach significance (median 16.0 months [95% CI, 6.1–22.0] vs. 12.3 months [6.2–33.9]; HR 0.65 [95% CI 0.38–1.11], p = 0.112). Conclusions Afatinib offered a longer PFS and comparable OS to chemotherapy in advanced lung SCC patients in a real-world setting, it may be considered as a 2nd line alternative treatment choice for immunotherapy unfit advanced lung SCC patients. |
| first_indexed | 2024-12-20T04:36:38Z |
| format | Article |
| id | doaj.art-8d57a7a736934ee896d5584c91819337 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T04:36:38Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-8d57a7a736934ee896d5584c918193372022-12-21T19:53:15ZengBMCBMC Cancer1471-24072021-11-012111910.1186/s12885-021-08920-3Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patientsYou-Yi Chen0Shih-Chieh Chang1Cheng-Yu Chang2Chun-Fu Chang3Yi-Chun Lai4Yu-Feng Wei5Chung-Yu Chen6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital Yunlin BranchDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University HospitalDivision of Pulmonary Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, and Department of Nursing, Cardinal Tien College of Healthcare and ManagementDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University HospitalDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University HospitalDepartment of Internal Medicine, E-Da Cancer HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital Yunlin BranchAbstract Background Limited treatment options exist for relapsed advanced lung squamous cell carcinoma (SCC), leading to poor outcomes compared with adenocarcinoma. This study aimed to investigate the efficacy of second-line afatinib versus chemotherapy in patients with advanced lung SCC who progressed after first-line chemotherapy. Methods In this retrospective, multisite cohort study, we recruited patients with initial locally advanced or metastatic lung SCC from four institutes in Taiwan between June 2014 and October 2020. The primary endpoint of this study was progression-free survival (PFS), and the secondary endpoints were the objective response rate (ORR), disease control rate (DCR), and overall survival (OS). Results The present study enrolled 108 patients: 19 received second-line afatinib, and 89 received second-line chemotherapy. The median ages were 71 and 67 years, respectively. PFS was significantly longer among patients who received afatinib than among those who received chemotherapy (median 4.7 months [95% confidence interval (CI), 0.1–7.5] vs. 2.6 months [95% CI, 0.9–6.7]; hazard ratio (HR) 0.53 [95% CI 0.32–0.88], p = 0.013). Compared with the chemotherapy group, OS was longer in the afatinib group but did not reach significance (median 16.0 months [95% CI, 6.1–22.0] vs. 12.3 months [6.2–33.9]; HR 0.65 [95% CI 0.38–1.11], p = 0.112). Conclusions Afatinib offered a longer PFS and comparable OS to chemotherapy in advanced lung SCC patients in a real-world setting, it may be considered as a 2nd line alternative treatment choice for immunotherapy unfit advanced lung SCC patients.https://doi.org/10.1186/s12885-021-08920-3AfatinibLung squamous cell carcinomaSecond-line treatment |
| spellingShingle | You-Yi Chen Shih-Chieh Chang Cheng-Yu Chang Chun-Fu Chang Yi-Chun Lai Yu-Feng Wei Chung-Yu Chen Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients BMC Cancer Afatinib Lung squamous cell carcinoma Second-line treatment |
| title | Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients |
| title_full | Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients |
| title_fullStr | Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients |
| title_full_unstemmed | Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients |
| title_short | Real-world effectiveness of second-line Afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy-naïve patients |
| title_sort | real world effectiveness of second line afatinib versus chemotherapy for the treatment of advanced lung squamous cell carcinoma in immunotherapy naive patients |
| topic | Afatinib Lung squamous cell carcinoma Second-line treatment |
| url | https://doi.org/10.1186/s12885-021-08920-3 |
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