Real-life comparison of the afatinib and first-generation tyrosine kinase inhibitors in nonsmall cell lung cancer harboring EGFR exon 19 deletion: a Turk Oncology Group (TOG) study

dc.authorid0000-0003-1018-1119
dc.authorid0000-0001-6235-7927
dc.authorid0000-0001-5460-4895
dc.authorid0000-0003-4642-3693
dc.authorid0000-0002-3353-344X
dc.authorid0000-0001-7680-4142
dc.authorscopusid57192957882
dc.authorscopusid57219456490
dc.authorscopusid57216342540
dc.authorscopusid57216333012
dc.authorscopusid57210790638
dc.authorscopusid57219706965
dc.authorscopusid57216873956
dc.authorwosiddogan, izzet/AAB-6635-2020
dc.authorwosidAvcı, Okan/ABG-8782-2021
dc.authorwosidYesil Cinkir, Havva/ABB-2690-2021
dc.authorwosidYücel, Şebnem/AAY-6737-2021
dc.authorwosidAktas, Burak Yasin/AAA-4726-2022
dc.authorwosidPaydas, Semra/F-3132-2018
dc.authorwosidalan, ozkan/AAV-5044-2020
dc.contributor.authorBilgin, Burak
dc.contributor.authorSendur, Mehmet Ali
dc.contributor.authorYücel, Şebnem
dc.contributor.authorÇelik, Emir
dc.contributor.authorÖzyükseler, Deniz Tataroğlu
dc.contributor.authorAyhan, Murat
dc.contributor.authorYalçın, Bülent
dc.contributor.authorAvcı, Okan
dc.date.accessioned2022-05-11T14:40:02Z
dc.date.available2022-05-11T14:40:02Z
dc.date.issued2021
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground The new second-generation tyrosine kinase inhibitors (TKIs) have superior survival outcome and worse toxicity profile when compared with first-generation TKIs according to the results of clinical trials. However, there are limited studies that investigate the efficacy and safety of the new generation TKIs in real-world patients. Thus, we aimed to compare the efficacy and safety of the afatinib, an irreversible inhibitor of ErbB family receptor, and first-generation TKIs in real-world patients. Materials and methods We included advanced nonsmall cell lung cancer (NSCLC) patients who had EGFR exon 19del mutation and treated with afatinib or first-generation TKIs as upfront treatment between 2016 and 2020. All patient's information was collected retrospectively. The study cohort was divided as afatinib arm and erlotinib/gefitinib arm. Results A total of 283 patients at the 24 oncology centers were included. The 89 and 193 of whom were treated with afatinib and erlotinib/gefitinib, respectively. After 12.9 months (mo) of follow-up, the median PFS was statistically longer in the afatinib arm than erlotinib/gefitinib arm (19.3 mo vs. 11.9 mo, p: 0.046) and the survival advantage was more profound in younger patients (< 65 years). The 24-mo overall survival rate was 76.1% and 49.5% in the afatinib arm and erlotinib/gefitinib arm, respectively. Although all-grade adverse event (AE) rates were similar between the two arms, grade 3-4 AE rates were higher in the afatinib arm (30.7% vs. 15.2%; p: 0.004). Discussion In our real-world study, afatinib has superior survival outcomes despite worse toxicity profile as inconsistent with clinical study results and it is the good upfront treatment option for younger patients and elderly patients who have good performance status.
dc.identifier.doi10.1007/s00432-020-03501-6
dc.identifier.endpage2152
dc.identifier.issn0171-5216
dc.identifier.issn1432-1335
dc.identifier.issue7en_US
dc.identifier.pmid33433657
dc.identifier.scopus2-s2.0-85099197058
dc.identifier.scopusqualityQ1
dc.identifier.startpage2145
dc.identifier.urihttps://doi.org/10.1007/s00432-020-03501-6
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8840
dc.identifier.volume147
dc.identifier.wosWOS:000608139100004
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAvcı, Okan
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofJournal of Cancer Research and Clinical Oncology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAfatinib
dc.subjectErlotinib
dc.subjectExon 19 del
dc.subjectGefitinib
dc.subjectNSCLC
dc.titleReal-life comparison of the afatinib and first-generation tyrosine kinase inhibitors in nonsmall cell lung cancer harboring EGFR exon 19 deletion: a Turk Oncology Group (TOG) study
dc.typeArticle

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