Real-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) study

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dc.contributor.authorGursoy P.
dc.contributor.authorTatli A.M.
dc.contributor.authorErdem D.
dc.contributor.authorGoker E.
dc.contributor.authorCelik E.
dc.contributor.authorDemirci N.S.
dc.contributor.authorSakin A.
dc.contributor.authorAtci M.M.
dc.contributor.authorBayram E.
dc.contributor.authorTelli T.A.
dc.contributor.authorBilgin B.
dc.contributor.authorBilici A.
dc.contributor.authorAkangunduz B.
dc.contributor.authorBalli S.
dc.contributor.authorDemirkazik A.
dc.contributor.authorSelçukbiricik F.
dc.contributor.authorMenekse S.
dc.contributor.authorCavdar E.
dc.contributor.authorOzturk A.
dc.contributor.authorBekmez E.T.
dc.contributor.authorTurhal S.
dc.contributor.authorKilickap S.
dc.contributor.authorYildirim H.Ç.
dc.contributor.authorOyan B.
dc.contributor.authorAksoy A.
dc.contributor.authorTurkoz F.P.
dc.contributor.authorKut E.
dc.contributor.authorKatgi N.
dc.contributor.authorSakalar T.
dc.contributor.authorAkyol M.
dc.contributor.authorEllez H.İ.
dc.contributor.authorTopcu A.
dc.contributor.authorErdoğan A.P.
dc.contributor.authorPilanci K.N.
dc.contributor.authorHedem E.
dc.contributor.authorArak H.
dc.contributor.authorAkdeniz N.
dc.contributor.authorAlan Ö.
dc.contributor.authorYapar B.
dc.contributor.authorNart D.
dc.contributor.authorYumuk P.F.
dc.date.accessioned2024-07-22T08:03:03Z
dc.date.available2024-07-22T08:03:03Z
dc.date.issued2023
dc.description.abstractObjectives: To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). Materials and methods: We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. Results: EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). Conclusion: In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
dc.identifier.DOI-ID10.1007/s00432-022-03984-5
dc.identifier.issn01715216
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12090
dc.language.isoEnglish
dc.publisherSpringer Science and Business Media Deutschland GmbH
dc.rightsAll Open Access; Green Open Access
dc.subjectAfatinib
dc.subjectCarcinoma, Non-Small-Cell Lung
dc.subjectErbB Receptors
dc.subjectErlotinib Hydrochloride
dc.subjectExons
dc.subjectGefitinib
dc.subjectHumans
dc.subjectLung Neoplasms
dc.subjectMutation
dc.subjectProtein Kinase Inhibitors
dc.subjectQuinazolines
dc.subjectRetrospective Studies
dc.subjectafatinib
dc.subjectepidermal growth factor receptor
dc.subjecterlotinib
dc.subjectgefitinib
dc.subjectafatinib
dc.subjectEGFR protein, human
dc.subjectepidermal growth factor receptor
dc.subjecterlotinib
dc.subjectgefitinib
dc.subjectprotein kinase inhibitor
dc.subjectquinazoline derivative
dc.subjectadult
dc.subjectanemia
dc.subjectArticle
dc.subjectcancer chemotherapy
dc.subjectcancer resistance
dc.subjectcancer survival
dc.subjectcomparative study
dc.subjectcontrolled study
dc.subjectdiarrhea
dc.subjectdrug withdrawal
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjecthypertransaminasemia
dc.subjectinterstitial lung disease
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmiddle aged
dc.subjectmucosa inflammation
dc.subjectmulticenter study
dc.subjectnon small cell lung cancer
dc.subjectoverall response rate
dc.subjectoverall survival
dc.subjectpeople by smoking status
dc.subjectprogression free survival
dc.subjectpyrosequencing
dc.subjectrash
dc.subjectreal time polymerase chain reaction
dc.subjectretrospective study
dc.subjectsurvival rate
dc.subjectsurvival time
dc.subjectexon
dc.subjectgenetics
dc.subjectlung tumor
dc.subjectmutation
dc.titleReal-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) study
dc.typeArticle

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