Afatinib may demonstrate clinical activity in patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) and asymptomatic brain metastasis, according to a study published in the Journal of Thoracic Oncology.
Researchers led by Martin Schuler, MD, of the University Duisburg-Essen in Germany looked at results of a phase 3 study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations (LUX-Lung 3) as well as a randomized, open-label phase 3 study of BIBW 2992 vs chemotherapy as first-line treatment for patients with stage 3B or 4 adenocarcinoma of the lung with EGFR-activating mutation (LUX-Lung 6).
In both studies, prespecific subgroup analyses were conducted for progression-free survival, overall survival, and objective response rate in patients with asymptomatic brain metastases at baseline.
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The researchers noted a trend toward improved progression-free survival with afatinib compared to chemotherapy in both studies among patients with brain metastases, with a similar magnitude in progression-free survival improvement with afatinib among patients without brain metastases.
Upon combined analysis, progression-free survival was significantly improved with afatinib compared with chemotherapy in patients with brain metastases. Afatinib was also found to improve objective response rate compared to chemotherapy in these patients.
- Schuler M, Wu Y, Hirsh V, et al. First-line afatinib versus chemotherapy in patients with non-small cell lung cancer and common epidermal growth factor receptor gene mutations and brain metastases [published online ahead of print January 24, 2016]. J Thorac Oncol. doi: http://dx.doi.org/10.1016/j.jtho.2015.11.014.