Afatinib vs erlotinib for second-line treatment of Chinese patients with advanced squamous cell carcinoma of the lung

Shun Lu, Wei Li, Caicun Zhou, Cheng-Ping Hu, Shukui Qin, Gang Cheng, Jifeng Feng, Jie Wang, Agnieszka Cseh, Barbara Peil, Neil Gibson, Eva Ehrnrooth, Li Zhang, Shun Lu, Wei Li, Caicun Zhou, Cheng-Ping Hu, Shukui Qin, Gang Cheng, Jifeng Feng, Jie Wang, Agnieszka Cseh, Barbara Peil, Neil Gibson, Eva Ehrnrooth, Li Zhang

Abstract

Background: The global Phase III LUX-Lung 8 trial (ClinicalTrials.gov: NCT01523587) identified significant improvements in progression-free survival (PFS), overall survival (OS), and patient-reported outcomes (PROs) with second-line afatinib vs erlotinib in patients with advanced squamous cell carcinoma (SCC) of the lung.

Materials and methods: We conducted a post hoc analysis of data for patients in LUX-Lung 8 from mainland China (n=67). Compared with erlotinib, afatinib reduced the risk of disease progression or death (PFS) in the Chinese subgroup by 30% (HR=0.70; 95% CI: 0.38-1.27).

Results: The risk of death was reduced by 31% (HR=0.69; 95% CI: 0.39-1.21). The proportion of Chinese patients with improvements in PROs also favored afatinib vs erlotinib (global health status/quality of life [QoL], 52.8% vs 29.6%, P=0.072; dyspnea, 47% vs 26%, P=0.091; "dyspnea walked", 44% vs 15%, P=0.017; QoL rate, 53% vs 26%, P=0.037).

Discussion: While this analysis was not powered to demonstrate differences compared to the overall trial population (OTP), and there were some differences in baseline characteristics (eg, the proportion of patients aged ≥65 years old), the benefits of afatinib treatment in Chinese patients with SCC of the lung appeared to be at least comparable to that observed in LUX-Lung 8. As with the OTP, the most common adverse events (AEs) with afatinib in the Chinese subgroup were diarrhea and rash/acne, and the incidence and type of the most frequently occurring AEs were similar.

Conclusion: The results suggest that afatinib represents a feasible treatment option for Chinese patients with advanced SCC of the lung following progression on platinum-based chemotherapy.

Keywords: Chinese patients; NSCLC; Phase III; afatinib; second-line; squamous cell carcinoma.

Conflict of interest statement

Disclosure CZ reports lecture fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Roche, and Sanofi. AC, BP, NG, and EE report employment by Boehringer Ingelheim. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) PFS (independent review) and (B) OS for the Chinese subgroup. Abbreviations: OS, overall survival; PFS, progression-free survival.
Figure 2
Figure 2
Long-term benefit of afatinib in LTRs (Chinese patients). Notes:aPatients ordered by treatment duration. Values are duration of treatment at the doses indicated. Abbreviations: LTRs, long-term responders; OS, overall survival.
Figure 3
Figure 3
Time to deterioration in coughing in the Chinese subgroup. Abbreviation: NE, not evaluable.

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Source: PubMed

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