TY - JOUR ID - 89610 TI - Effectiveness and Tolerability of First-Line Afatinib for Advanced EGFR-Mutant Non-Small Cell Lung Cancer in Vietnam JO - Asian Pacific Journal of Cancer Prevention JA - APJCP LA - en SN - 1513-7368 AU - Vu, Thanh Ha AU - Nguyen, Hoa Thi Thai AU - Dao, Linh Khanh AU - Duong, Chi Khanh AU - Nguyen, Cao Van AU - Doan, Tuyet Thi AU - Nguyen, Hang Thi Thuy AU - Hoang, Hung Huy AU - Dinh, Dung Khac AU - Le, Giang Vinh AU - Vu, Thanh Thi AU - Truong, Minh Cong AU - Nguyen, Long Thanh AD - Department of Medical Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam. AD - Department of Oncology, Hanoi Medical University, Hanoi, Vietnam. Y1 - 2021 PY - 2021 VL - 22 IS - 5 SP - 1581 EP - 1590 KW - non small cell lung cancer (NSCLC) KW - advanced stage KW - EGFR mutation KW - second generation EGFR TKI KW - real-world DO - 10.31557/APJCP.2021.22.5.1581 N2 - Background: We aimed to evaluate the effectiveness and tolerability of Afatinib as first-line treatment of advanced epidermal growth factor receptor (EGFR) mutant non small cell lung cancer (NSCLC) in a real-world setting. Patients and methods: This is a retrospective study of Vietnamese patients  with advanced EGFR-mutant NSCLC treated with first-line afatinib at the National Cancer Hospital from 1st January 2018 to 31st October 2020. Patients’ demographic, clinical and treatment data were captured. Objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF) and tolerability were evaluated. We used Kaplan-Meier curve and log-rank test for survival, and Cox regression model for multivariate analysis. Results: A total of 44 patients were included. Common EGFR mutations (Del 19/L858R) were detected in 61% patients. Fifty percent of patients with uncommon mutations had compound mutations of G719X, L861Q and S768I. The ORR was 75% while DCR rate was 98%. The median TTF was 12.3 months (95% CI: 7.2-17.3); the mTTFs were 12.3 and 10.8 months for patients with common and uncommon mutations (p = 0.001), respectively, and 14.0 and 7.5 months for patients with Del 19 and L858R mutations (p = 0.067), respectively. Afatinib 30 mg once daily was the most common starting (77%) and maintenance (64%) doses. The mTTFs were 12.3 and 7.5 months for patients with 30 mg starting dose vs 40 mg dose (p = 0.256), respectively. Diarrhea, skin rash, paronychia and fatigue were observed in 32%, 30%, 25% and 9%, respectively. There was no grade 4 toxicity except three patients with grade 3 paronychia. Conclusions: First-line afatinib is beneficial for Vietnamese patients with advanced EGFR-mutant NSCLC with a good response rate and prolonged TTF with manageable adverse event profile. Baseline brain metastasis status and starting doses do not significantly impact TTF.   UR - https://journal.waocp.org/article_89610.html L1 - https://journal.waocp.org/article_89610_8a3c622eb4ac10316ca01d4e72ac3e22.pdf ER -