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P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Presentations: 1
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
P1.01-60 - Preventing and Treating Brain Metastases with Three First-Line EGFR-TKI in Patients with EGFR Mutation Advanced NSCLC (ID 12010)
16:45 - 18:00 | Presenting Author(s): Chien-Chung Lin
Brain metastases (BM) are common in advanced non-small cell lung cancer (NSCLC), and the prognosis is poor with few therapeutic options. This retrospective study evaluated the efficacy of three epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in preventing and treating BM in patients with EGFR mutation-positive advanced NSCLC.a9ded1e5ce5d75814730bb4caaf49419 Method
All patients with EGFR mutation-positive advanced NSCLC who visited a tertiary referral center from December 1, 2013, to November 30, 2017, were analyzed retrospectively. These patients received gefitinib, erlotinib, or afatinib until disease progression, death, or intolerable adverse events. The cumulative incidence of subsequent BM and the progression-free survival (PFS) and overall survival (OS) of both the BM patients and non-BM patients were estimated by the Kaplan-Meier method and compared using the log-rank test. We performed Cox proportional hazards regression for the predictors of subsequent BM and determinants of PFS and OS.
A total of 306 patients with newly diagnosed or recurrent NSCLC were enrolled. Among these patients, 116, 75, and 115 received first-line gefitinib, erlotinib, and afatinib, respectively. The patients who received afatinib had a better PFS (12.7 versus 9.8 months, p=0.001) and OS (39.1 versus 22.0 months, p=0.035) than those who received gefitinib. The cumulative incidences of subsequent BM were similar among the patients who received different TKIs (p=0.80). Patients with initial BM were associated with a shorter PFS (p < 0.001) and OS (p=0.015) than those without BM. Among the initial BM patients, there were no differences in median PFS (p=0.34) and median OS (p=0.46) in the three EGFR-TKI groups.
Our data suggested afatinib provided significant benefits in terms of PFS and OS as well as preventing subsequent BM compared to gefitinib, in addition to providing the same effectiveness in treating BM as gefitinib6f8b794f3246b0c1e1780bb4d4d5dc53