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The Impact of Afatinib on Survival in Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Controlled

Chi Wang1, Yun Li1, Li Ke2

  • 1Central Laboratory of Medical Research Centre, Anhui Provincial Hospital, Anhui Medical University, Hefei, 230001, China.

Journal of Cancer
|March 12, 2019
PubMed

Insights

Afatinib significantly improves survival and response rates for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. This meta-analysis confirms its efficacy without increasing fatal adverse events, highlighting its clinical potential.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is FDA-approved for advanced non-small cell lung cancer (NSCLC) with EGFR mutations.
  • The study aims to evaluate the efficacy and safety of afatinib in advanced NSCLC through a comprehensive meta-analysis.

Purpose of the Study:

  • To assess the efficacy of afatinib in advanced NSCLC, focusing on progression-free survival (PFS), overall survival (OS), and overall response rate (ORR).
  • To evaluate the safety profile of afatinib, including the incidence of grade 3/4 adverse events and fatal adverse events (FAEs).
  • To conduct subgroup analyses based on control type for all endpoints to provide nuanced insights.

Main Methods:

  • Systematic literature search conducted across PubMed, PMC database, EMBASE, Cochrane Library, and Web of Science.
  • Inclusion of seven randomized controlled trials (RCTs) involving a total of 3093 patients.
  • Statistical analysis using meta-analysis to compare afatinib with control groups for efficacy and safety endpoints.

Main Results:

  • Afatinib significantly prolonged PFS (HR = 0.57, P = 0.00) and increased OS (HR = 0.91, P = 0.04) and ORR (RR = 1.82, P = 0.01) compared to control groups.
  • Significant increases in the incidence of diarrhea (RR = 8.9, P = 0.00), rash (RR = 7.31, P = 0.01), and stomatitis (RR = 6.45, P = 0.03) were observed with afatinib.
  • No significant difference in fatal adverse events (FAEs) was found between afatinib and control groups (RR = 0.75, P = 0.41).

Conclusions:

  • Afatinib demonstrates significant efficacy in extending survival and improving response rates in advanced NSCLC patients.
  • The safety profile indicates an increased risk of specific adverse events like diarrhea, rash, and stomatitis, but not fatal adverse events.
  • Afatinib is a promising EGFR-TKI with substantial clinical potential for treating advanced NSCLC.
Keywords:
ImmunotherapyMeta-analysisNon-small cell lung cancerResponse rateSurvival

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