ASCO 2014 - Abstract 8004

ASCO 2014. Abstract 8004. Overall survival (OS) in patients (pts) with advanced non-small cell lung cancer (NSCLC) harboring common (Del19/L858R) epidermal growth factor receptor mutations (EGFR mut): Pooled analysis of two large open-label phase III studies (LUX-Lung 3 [LL3] and LUX-Lung 6 [LL6]) comparing afatinib with chemotherapy (CT).

James Chih-Hsin Yang, Lecia V. Sequist, Martin H. Schuler, Tony Mok, Nobuyuki Yamamoto, Kenneth John O'Byrne, Vera Hirsh, Sarayut Lucien Geater, Caicun Zhou, Dan Massey, Victoria Zazulina, Yi-Long Wu; National Taiwan University Hospital, Taipei, Taiwan; Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; The Chinese University of Hong Kong, Hong Kong, China; Wakayama Medical University, Wakayama, Japan; St. James's Hospital, Dublin, Ireland; McGill University, Montreal, QC, Canada; Prince of Songkla University, Songkhla, Thailand; Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; Boehringer Ingelheim Ltd, Bracknell, Berkshire, United Kingdom; Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China

The use of EGFR TKI inhibitors in patients whose tumors harbour an EGFR mutation has become standard of care in Canada.

First generation TKI’s such as gefinib and erlotinib showed improvement in progression free survival over chemotherapy in the pivotal trials IPASS and EURTAC. Overall survival (21-22 months) was not different and an expected finding given the high rate of crossover for both arms in both trials.

The second generation EGFR TKI, afatinib was tested in the first line setting in LUX Lung 3 and LUX Lung 6. The progression free survival of 13.6 months and 11 months were impressive. As a pan HER inhibitor which also blocks the acquired T790 mutation, the results were explained.

The overall survival was presented as a pooled analysis at this year’s ASCO. Patients treated with afatinib had an overall survival of 27.3 months compared to chemotherapy 24.3, p<0.037 (Figure 1). This was even more pronounced in patients who had the common mutation of deletion 19. An outstanding survival of 31.7 months (Figures 2 and 3) was found. This is the first EGFR TKI in the first line setting to have a benefit in overall survival. This will be practice changing in my patients.
— CARE Lung Cancer Faculty Perspective
Figure 1

Figure 1

Figures 2 and 3

Figures 2 and 3