In a nutshell
This study compared afatinib (Gilotriff) and gefitinib (Iressa) in non-small cell lung cancer (NSCLC) patients with positive EGFR mutations. The authors concluded that afatinib was associated with better treatment outcomes than gefitinib.
Some background
Mutations (genetic changes) in the epidermal growth factor receptor (EGFR) has been associated with the growth of NSCLC. Certain drugs can target this type of cancer specifically. These are called EGFR-TKIs and include both afatinib and gefitinib. There have been several studies showing the effectiveness of both drugs. However, it remains unclear which is more effecive in treating NSCLC patients with positive EGFR mutations.
Methods & findings
319 NSCLC patients with positive EGFR mutations were included in this study. Patients were randomly assigned to receive either afatinib (group 1) or gefitinib (group 2). Patients were followed for an average of 27.3 months.
Progression-free survival (time from treatment until disease progression or death) was 11 months for group 1 and 10.9 months for group 2. Time to treatment failure (due to patient discontinuation, severe side effects, progression, or death) was 13.7 months for group 1. This was significantly longer than 11.5 months for group 2. Overall, group 1 continued treatment 27% longer.
No significant differences in the rate of side effects were noted between treatment groups. The most common side effects were diarrhoea, rash, and acne (reported in 1 to 13% of patients). 6% of patients in both groups discontinued treatment due to the side effects. 1 patient in group 2 died due to complications from treatment.
The bottom line
The authors concluded that afatinib was more effective than gefitinib in treating EGFR-mutation-positive NSCLC.
The fine print
This trial was funded by the manufacturers of afatinib.
Published By :
The Lancet. Oncology
Date :
Apr 12, 2016
