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Afatinib in Advanced Pretreated Non-Small-Cell Lung Cancer—A Canadian Experience

Princess Margaret Cancer Centre, University Health Network, 7-913 700 University Avenue, Toronto, ON M5G 1Z5, Canada
BC Cancer–Vancouver Centre, Vancouver, BC, Canada
University of Calgary, Calgary, AB, Canada
London Health Sciences Centre, London, ON, Canada
Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
Author to whom correspondence should be addressed.
Senior responsible co-authors.
These authors contributed equally to the present work.
Curr. Oncol. 2018, 25(5), 385-390;
Submission received: 1 July 2018 / Revised: 2 August 2018 / Accepted: 5 September 2018 / Published: 1 October 2018


Background: Afatinib, an irreversible epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI), is approved for first-line therapy in advanced EGFR mutation–positive non-small-cell lung cancer (NSCLC) and has previously demonstrated activity after failure of chemotherapy and reversible EGFR TKI, with improved response and progression-free survival, compared with placebo. Outcomes in pretreated patients with advanced NSCLC receiving afatinib through a Canadian special access program (sap) are reported here. Methods: Patients with NSCLC progressing after at least 1 line of chemotherapy and an EGFR TKI were eligible to enrol in the sap. Characteristics of patients from the two largest accruing Canadian centres were retrospectively reviewed, including demographics, disease and treatment data, and patient outcomes. Results: The 53 patients who received afatinib (57% women, 51% never-smokers, 26% of East Asian ethnicity, and 66% with adenocarcinoma) had a median age of 59 years. EGFR mutations were documented in 25%, and EGFR wildtype in 8%. All patients had received prior EGFR TKI treatment, with 42% achieving a response. Patients took afatinib for a median of 2 months (range: 0–26 months); 17% required 1 or more dose reductions. Of 47 evaluable patients receiving afatinib, 10 experienced tumour shrinkage, and 11, stable disease. Median survival from afatinib initiation was 5 months (95% confidence interval: 2 months to 8 months). Grade 3 or greater diarrhea, rash, paronychia, and stomatitis were seen in 9%, 11%, 6%, and 4% of patients respectively. Conclusions: In an unselected population of pretreated patients with advanced NSCLC after TKI failure, median survival with afatinib therapy was 5 months. Through a sap, afatinib demonstrated activity in clinical practice, with manageable toxicity.
Keywords: afatinib; non-small-cell lung cancer afatinib; non-small-cell lung cancer

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MDPI and ACS Style

Ezeife, D.A.; Melosky, B.; Tudor, R.; Lin, S.; Lau, A.; Panzarella, T.; Leighl, N.B. Afatinib in Advanced Pretreated Non-Small-Cell Lung Cancer—A Canadian Experience. Curr. Oncol. 2018, 25, 385-390.

AMA Style

Ezeife DA, Melosky B, Tudor R, Lin S, Lau A, Panzarella T, Leighl NB. Afatinib in Advanced Pretreated Non-Small-Cell Lung Cancer—A Canadian Experience. Current Oncology. 2018; 25(5):385-390.

Chicago/Turabian Style

Ezeife, D.A., B. Melosky, R. Tudor, S. Lin, A. Lau, T. Panzarella, and N.B. Leighl. 2018. "Afatinib in Advanced Pretreated Non-Small-Cell Lung Cancer—A Canadian Experience" Current Oncology 25, no. 5: 385-390.

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