The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study
Abstract Objectives The irreversible epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) afatinib and dacomitinib are approved for first-line treatment of EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and dacomi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-024-11956-w |
| _version_ | 1797274329584500736 |
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| author | Wen-Chien Cheng Chi-Chien Lin Wei-Chih Liao Yu-Chao Lin Chia-Hung Chen Hung-Jen Chen Chih-Yen Tu Te-Chun Hsia |
| author_facet | Wen-Chien Cheng Chi-Chien Lin Wei-Chih Liao Yu-Chao Lin Chia-Hung Chen Hung-Jen Chen Chih-Yen Tu Te-Chun Hsia |
| author_sort | Wen-Chien Cheng |
| collection | DOAJ |
| description | Abstract Objectives The irreversible epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) afatinib and dacomitinib are approved for first-line treatment of EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and dacomitinib in this setting. Materials and methods Between September 2020 and March 2023, we retrospectively recruited patients diagnosed with advanced-stage EGFR-mutant NSCLC who were treated with first-line irreversible EGFR-TKIs. The enrolled patients were assigned to two groups based on whether they received afatinib or dacomitinib. Results A total of 101 patients were enrolled in the study (70 to afatinib and 31 to dacomitinib). The partial response rates (PR) for first-line treatment with afatinib and dacomitinib were 85.7 and 80.6% (p = 0.522). The median progression-free survival (PFS) (18.9 vs. 16.3 months, p = 0.975) and time to treatment failure (TTF) (22.7 vs. 15.9 months, p = 0.324) in patients with afatinib and dacomitinib treatment were similar. There was no significant difference observed in the median PFS (16.1 vs. 18.9 months, p = 0.361) and TTF (32.5 vs. 19.6 months, p = 0.182) between patients receiving the standard dose and those receiving the reduced dose. In terms of side effects, the incidence of diarrhea was higher in the afatinib group (75.8% vs. 35.5%, p < 0.001), while the incidence of paronychia was higher in the dacomitinib group (58.1% vs. 31.4%, p = 0.004). The PFS (17.6 vs. 24.9 months, p = 0.663) and TTF (21.3 vs. 25.1 months, p = 0.152) were similar between patients younger than 75 years and those older than 75 years. Conclusion This study showed that afatinib and dacomitinib had similar effectiveness and safety profiles. However, they have slightly different side effects. Afatinib and dacomitinib can be safely administered to patients across different age groups with appropriate dose reductions. |
| first_indexed | 2024-03-07T14:56:54Z |
| format | Article |
| id | doaj.art-d39ef3124fc64d44bd1141cb823d8225 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-07T14:56:54Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-d39ef3124fc64d44bd1141cb823d82252024-03-05T19:24:24ZengBMCBMC Cancer1471-24072024-02-0124111110.1186/s12885-024-11956-wThe difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational studyWen-Chien Cheng0Chi-Chien Lin1Wei-Chih Liao2Yu-Chao Lin3Chia-Hung Chen4Hung-Jen Chen5Chih-Yen Tu6Te-Chun Hsia7Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalInstitute of Biomedical Science, the iEGG and Animal Biotechnology Center, Advanced Plant and Food Crop Biotechnology Center, National Chung-Hsing UniversityDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University HospitalAbstract Objectives The irreversible epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) afatinib and dacomitinib are approved for first-line treatment of EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and dacomitinib in this setting. Materials and methods Between September 2020 and March 2023, we retrospectively recruited patients diagnosed with advanced-stage EGFR-mutant NSCLC who were treated with first-line irreversible EGFR-TKIs. The enrolled patients were assigned to two groups based on whether they received afatinib or dacomitinib. Results A total of 101 patients were enrolled in the study (70 to afatinib and 31 to dacomitinib). The partial response rates (PR) for first-line treatment with afatinib and dacomitinib were 85.7 and 80.6% (p = 0.522). The median progression-free survival (PFS) (18.9 vs. 16.3 months, p = 0.975) and time to treatment failure (TTF) (22.7 vs. 15.9 months, p = 0.324) in patients with afatinib and dacomitinib treatment were similar. There was no significant difference observed in the median PFS (16.1 vs. 18.9 months, p = 0.361) and TTF (32.5 vs. 19.6 months, p = 0.182) between patients receiving the standard dose and those receiving the reduced dose. In terms of side effects, the incidence of diarrhea was higher in the afatinib group (75.8% vs. 35.5%, p < 0.001), while the incidence of paronychia was higher in the dacomitinib group (58.1% vs. 31.4%, p = 0.004). The PFS (17.6 vs. 24.9 months, p = 0.663) and TTF (21.3 vs. 25.1 months, p = 0.152) were similar between patients younger than 75 years and those older than 75 years. Conclusion This study showed that afatinib and dacomitinib had similar effectiveness and safety profiles. However, they have slightly different side effects. Afatinib and dacomitinib can be safely administered to patients across different age groups with appropriate dose reductions.https://doi.org/10.1186/s12885-024-11956-wNon-small cell lung cancer (NSCLC)Epidermal growth factor receptor (EGFR)DacomitinibAfatinib |
| spellingShingle | Wen-Chien Cheng Chi-Chien Lin Wei-Chih Liao Yu-Chao Lin Chia-Hung Chen Hung-Jen Chen Chih-Yen Tu Te-Chun Hsia The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study BMC Cancer Non-small cell lung cancer (NSCLC) Epidermal growth factor receptor (EGFR) Dacomitinib Afatinib |
| title | The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study |
| title_full | The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study |
| title_fullStr | The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study |
| title_full_unstemmed | The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study |
| title_short | The difference between dacomitinib and afatinib in effectiveness and safety in first-line treatment of patients with advanced EGFR-mutant non-small cell lung cancer: a real-world observational study |
| title_sort | difference between dacomitinib and afatinib in effectiveness and safety in first line treatment of patients with advanced egfr mutant non small cell lung cancer a real world observational study |
| topic | Non-small cell lung cancer (NSCLC) Epidermal growth factor receptor (EGFR) Dacomitinib Afatinib |
| url | https://doi.org/10.1186/s12885-024-11956-w |
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