Long term efficacy of first-line afatinib and the clinical utility of ctDNA monitoring in patients with suspected or confirmed EGFR mutant non-small cell lung cancer who were unsuitable for chemotherapy
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View abstract on PubMed
Summary
This summary is machine-generated.Afatinib offers long-term benefit for EGFR-mutant non-small cell lung cancer (NSCLC) patients unsuitable for chemotherapy. Serial ctDNA monitoring aids in identifying mutations and predicting treatment outcomes.
Area Of Science
- Oncology
- Genetics
- Pharmacology
Background
- Investigating long-term outcomes of first-line afatinib in comorbid patients with EGFR-mutant non-small cell lung cancer (NSCLC) not suitable for chemotherapy.
- Assessing the clinical utility of serial circulating tumor DNA (ctDNA) monitoring in this patient population.
Purpose Of The Study
- To evaluate the efficacy and long-term safety of afatinib in a specific NSCLC patient cohort.
- To determine the role of ctDNA analysis in identifying EGFR mutations and predicting treatment response.
Main Methods
- A multicentre, single-arm, phase II trial (TIMELY) involving 39 patients treated with oral afatinib (40 mg daily).
- ctDNA analysis was performed at baseline and every 12 weeks; primary endpoint was progression-free survival (PFS).
Main Results
- Median follow-up was 98 months; median PFS was 7.9 months.
- Eight additional EGFR mutations were identified by ctDNA compared to tissue genotyping.
- ctDNA clearance correlated with improved PFS and overall survival (OS); 18% of patients had long-term treatment benefit (>18 months).
Conclusions
- Afatinib is a viable first-line option for EGFR-mutant NSCLC patients identified by tissue or ctDNA, including those with comorbidities.
- Plasma ctDNA testing enhances EGFR mutation detection and ctDNA clearance predicts better PFS and OS, indicating its clinical utility.
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