“In the randomized, phase 3 LUX-Lung 8 trial, afatinib significantly improved overall survival compared to erlotinib, reducing the risk of death by 19% in patients with advanced SCC of the lung, previously treated with first-line chemotherapy,” Shirish M. Gadgeel, MD, team leader of the thoracic oncology multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit, MI, said in an interview with Cancer Therapy Advisor.

“This improvement in survival with afatinib is similar to the significant delay in the progression of lung cancer (primary endpoint) reported last year. In addition, patients treated with afatinib on this trial had improvement in cancer-related cough and shortness of breath compared to erlotinib.”


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In regard to safety, the adverse event profiles were similar between the two treatment arms. More patients in the afatinib arm experienced treatment-related grade 3 diarrhea and grade 3 stomatitis, while there was a higher incidence of grade 3 rash or acne in the erlotinib arm.1

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“Based on the efficacy results of LUX-Lung 8 and the similar toxicity rates in patients treated with afatinib or erlotinib, afatinib is the preferred EGFR-TKI for the treatment of advanced squamous cell lung cancer with progressive cancer following treatment with a platinum-based chemotherapy combination,” Dr. Gadgeel said.

“Squamous cell carcinoma of the lung is associated with poor prognosis, with less than 5% of patients surviving for 5 years or longer. The phase 3 LUX-Lung 8 study is the first prospective trial comparing two TKIs in patients with advanced SCC and therefore marks an advancement in addressing the critical need for treatments that target this disease with poor outcomes,” Dr. Gadgeel concluded.

References

  1. Soria JC, Felip E, Cobo M, et al. Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8): an open-label randomised controlled phase 3 trial. Lancet Oncol. July 3, 2015. [Epub ahead of print] doi: 10.1016/S1470-2045(15)00006-6.
  2. American Cancer Society. Non-Small Cell Lung Cancer. http://www.cancer.org/cancer/lungcancer-non-smallcell/. Accessed July 14, 2015.
  3. NCCN Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer. V7.2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed July 14, 2015.