Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study
Background: Although bevacizumab in combination with afatinib or erlotinib is an effective and safe first-line therapy for advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), there are very few clinical data comparing afatinib and erlotinib combined with beva...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-07-01
|
| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359221113278 |
| _version_ | 1811287195965718528 |
|---|---|
| author | Suey-Haur Lee Yu-Ching Lin Li-Chung Chiu Jia-Shiuan Ju Pi-Hung Tung Allen Chung-Cheng Huang Shih-Hong Li Yueh-Fu Fang Chih-Hung Chen Scott Chih-Hsi Kuo Chin-Chou Wang Cheng-Ta Yang Ping-Chih Hsu |
| author_facet | Suey-Haur Lee Yu-Ching Lin Li-Chung Chiu Jia-Shiuan Ju Pi-Hung Tung Allen Chung-Cheng Huang Shih-Hong Li Yueh-Fu Fang Chih-Hung Chen Scott Chih-Hsi Kuo Chin-Chou Wang Cheng-Ta Yang Ping-Chih Hsu |
| author_sort | Suey-Haur Lee |
| collection | DOAJ |
| description | Background: Although bevacizumab in combination with afatinib or erlotinib is an effective and safe first-line therapy for advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), there are very few clinical data comparing afatinib and erlotinib combined with bevacizumab. We performed a retrospective multicenter analysis for the comparison of two combination therapies. Methods: Between May 2015 and October 2020, data of 135 stage IIIB/IV EGFR-mutated NSCLC patients receiving first-line afatinib or erlotinib combined with bevacizumab combination therapy in Linkou, Keelung, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals were retrieved and retrospectively analyzed. Results: In all, 67 patients received afatinib plus bevacizumab, and 68 patients received erlotinib plus bevacizumab. Afatinib combined with bevacizumab had an objective response rate (ORR) of 82.1% and a disease control rate (DCR) of 97.0%, and the ORR and DCR were 83.8 and 95.6%, respectively, in the erlotinib combined with bevacizumab group ( p = 0.798 and p = 1.000). The median progression-free survival was 20.7 and 20.3 months for the afatinib plus bevacizumab group and the erlotinib plus bevacizumab group, respectively [hazard ratio (HR) = 1.02; 95% confidence interval (CI), 0.891–1.953; p = 0.167). The overall survival was 41.9 and 51.0 months for the afatinib plus bevacizumab group and erlotinib plus bevacizumab group, respectively (HR = 1.42; 95% CI, 0.829–2.436; p = 0.201). The secondary EGFR-T790M mutation rates after disease progression were 44% in the afatinib plus bevacizumab group and 58.8% in the erlotinib plus bevacizumab group ( p = 0.165). Skin toxicity was the most frequent treatment-related adverse event (AE) in both treatment groups. Diarrhea, an AE, occurred significantly more frequently in the afatinib plus bevacizumab group than in the erlotinib plus bevacizumab group ( p < 0.05). Conclusion: Afatinib combined with bevacizumab was equally as effective as erlotinib combined with bevacizumab for untreated advanced EGFR-mutated NSCLC. Prospective clinical studies that explore bevacizumab combined with afatinib or erlotinib for advanced EGFR-mutated NSCLC are warranted. |
| first_indexed | 2024-04-13T03:14:31Z |
| format | Article |
| id | doaj.art-c4d2ac6158d7496993153c06a2d2085c |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-13T03:14:31Z |
| publishDate | 2022-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-c4d2ac6158d7496993153c06a2d2085c2022-12-22T03:04:57ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-07-011410.1177/17588359221113278Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis studySuey-Haur LeeYu-Ching LinLi-Chung ChiuJia-Shiuan JuPi-Hung TungAllen Chung-Cheng HuangShih-Hong LiYueh-Fu FangChih-Hung ChenScott Chih-Hsi KuoChin-Chou WangCheng-Ta YangPing-Chih HsuBackground: Although bevacizumab in combination with afatinib or erlotinib is an effective and safe first-line therapy for advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), there are very few clinical data comparing afatinib and erlotinib combined with bevacizumab. We performed a retrospective multicenter analysis for the comparison of two combination therapies. Methods: Between May 2015 and October 2020, data of 135 stage IIIB/IV EGFR-mutated NSCLC patients receiving first-line afatinib or erlotinib combined with bevacizumab combination therapy in Linkou, Keelung, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals were retrieved and retrospectively analyzed. Results: In all, 67 patients received afatinib plus bevacizumab, and 68 patients received erlotinib plus bevacizumab. Afatinib combined with bevacizumab had an objective response rate (ORR) of 82.1% and a disease control rate (DCR) of 97.0%, and the ORR and DCR were 83.8 and 95.6%, respectively, in the erlotinib combined with bevacizumab group ( p = 0.798 and p = 1.000). The median progression-free survival was 20.7 and 20.3 months for the afatinib plus bevacizumab group and the erlotinib plus bevacizumab group, respectively [hazard ratio (HR) = 1.02; 95% confidence interval (CI), 0.891–1.953; p = 0.167). The overall survival was 41.9 and 51.0 months for the afatinib plus bevacizumab group and erlotinib plus bevacizumab group, respectively (HR = 1.42; 95% CI, 0.829–2.436; p = 0.201). The secondary EGFR-T790M mutation rates after disease progression were 44% in the afatinib plus bevacizumab group and 58.8% in the erlotinib plus bevacizumab group ( p = 0.165). Skin toxicity was the most frequent treatment-related adverse event (AE) in both treatment groups. Diarrhea, an AE, occurred significantly more frequently in the afatinib plus bevacizumab group than in the erlotinib plus bevacizumab group ( p < 0.05). Conclusion: Afatinib combined with bevacizumab was equally as effective as erlotinib combined with bevacizumab for untreated advanced EGFR-mutated NSCLC. Prospective clinical studies that explore bevacizumab combined with afatinib or erlotinib for advanced EGFR-mutated NSCLC are warranted.https://doi.org/10.1177/17588359221113278 |
| spellingShingle | Suey-Haur Lee Yu-Ching Lin Li-Chung Chiu Jia-Shiuan Ju Pi-Hung Tung Allen Chung-Cheng Huang Shih-Hong Li Yueh-Fu Fang Chih-Hung Chen Scott Chih-Hsi Kuo Chin-Chou Wang Cheng-Ta Yang Ping-Chih Hsu Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study Therapeutic Advances in Medical Oncology |
| title | Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study |
| title_full | Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study |
| title_fullStr | Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study |
| title_full_unstemmed | Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study |
| title_short | Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study |
| title_sort | comparison of afatinib and erlotinib combined with bevacizumab in untreated stage iiib iv epidermal growth factor receptor mutated lung adenocarcinoma patients a multicenter clinical analysis study |
| url | https://doi.org/10.1177/17588359221113278 |
| work_keys_str_mv | AT sueyhaurlee comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT yuchinglin comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT lichungchiu comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT jiashiuanju comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT pihungtung comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT allenchungchenghuang comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT shihhongli comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT yuehfufang comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT chihhungchen comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT scottchihhsikuo comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT chinchouwang comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT chengtayang comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy AT pingchihhsu comparisonofafatinibanderlotinibcombinedwithbevacizumabinuntreatedstageiiibivepidermalgrowthfactorreceptormutatedlungadenocarcinomapatientsamulticenterclinicalanalysisstudy |