Relationship between Epidermal Growth Factor Receptor Mutations and Adverse Events in Non-Small Cell Lung Cancer
Sayaka Yamashita1, Hiroaki Tanaka1, Takakiyo Tatsumichi1
1Department of Pharmacy, Kagawa University Hospital, Kagawa 761-0793, Japan.
Abstract:
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors such as afatinib are used for non-small cell lung cancer (NSCLC) and show varying efficacy depending on EGFR gene mutation. Few studies have examined the relationship between EGFR gene mutations and the adverse events of afatinib in NSCLC. This retrospective study included 32 Japanese patients with NSCLC with EGFR gene mutation who were treated with afatinib between May 2014 and August 2018 at Kagawa University Hospital. Among the 32 Japanese patients with NSCLC treated with afatinib, 19 patients were positive for exon 19 deletion mutation (Del 19) and 13 patients were negative for Del 19. The incidence of grade ≥ 2 skin rash was slightly higher in patients positive for Del 19 (42.1% vs. 7.7%, P = 0.050). No significant differences were detected in other adverse events between the two patient groups. Patients positive for Del 19 also showed significantly longer median progression-free survival (288 vs. 84 days, P = 0.049). Our study indicates a higher incidence of skin rash associated with afatinib treatment in Japanese patients with NSCLC positive for Del 19 compared with patients without Del 19. The Del 19 positive patient group also showed better progression-free survival. J. Med. Invest. 68 : 125-128, February, 2021.
Insights
Afatinib treatment for non-small cell lung cancer (NSCLC) showed a higher incidence of skin rash in patients with EGFR exon 19 deletion (Del 19) mutations. These Del 19 positive patients also experienced longer progression-free survival.
Area of Science:
- Oncology
- Pharmacogenomics
- Medical Research
Background:
- Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) like afatinib are crucial for non-small cell lung cancer (NSCLC) treatment.
- Efficacy of EGFR-TKIs varies based on specific EGFR gene mutations.
- Limited research exists on the correlation between EGFR mutations and afatinib-induced adverse events in NSCLC.
Purpose of the Study:
- To investigate the relationship between EGFR gene mutations and adverse events associated with afatinib treatment in Japanese NSCLC patients.
- To compare the incidence of adverse events and progression-free survival between NSCLC patients with and without EGFR exon 19 deletion (Del 19) mutations.
Main Methods:
- Retrospective study of 32 Japanese NSCLC patients treated with afatinib.
- Patients were categorized based on the presence (Del 19 positive) or absence (Del 19 negative) of EGFR exon 19 deletion.
- Adverse events and progression-free survival were analyzed between the two groups.
Main Results:
- A slightly higher incidence of grade ≥2 skin rash was observed in Del 19 positive patients (42.1%) compared to Del 19 negative patients (7.7%) (P=0.050).
- No significant differences in other adverse events were found between the groups.
- Del 19 positive patients demonstrated significantly longer median progression-free survival (288 days vs. 84 days, P=0.049).
Conclusions:
- Afatinib treatment in Japanese NSCLC patients with EGFR Del 19 mutations is associated with a higher risk of skin rash.
- EGFR Del 19 positive NSCLC patients treated with afatinib exhibit improved progression-free survival.
- Findings suggest a potential link between specific EGFR mutations and both toxicity profiles and treatment outcomes with afatinib.
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