Afatinib Helps Delay Lung Cancer Progression

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Afatinib significantly improves progression-free survival among patients with advanced lung cancer that harbors certain genetic mutations compared with standard chemotherapy.

Results from a phase 3 international trial showed that the targeted drug afatinib significantly improves progression-free survival among patients with advanced lung cancer that harbors certain genetic mutations compared with standard chemotherapy.

Researchers randomly assigned 345 patients with epidermal growth factor receptor (EGFR)-driven lung adenocarcinoma, a subtype of non-small cell lung cancer, to either afatinib or a chemotherapy regimen of Alimta (pemetrexed) and cisplatin.

Afatinib was shown to delay disease progression by more than four months compared with chemotherapy. Patients on afatinib had 11.1 months of progression-free survival versus 6.9 months experienced by patients on the chemotherapy regimen. In a group of patients with the most common types of EGFR mutations, progression-free survival was double that of standard therapy (13.6 months versus 6.9 months).

Studies have shown that afatinib inactivates the EGFR pathway longer than other EGFR-targeted therapies, such as Iressa (gefitinib) and Tarceva (erlotinib). Afatinib blocks the broader HER family of receptors, including HER2 and HER4.

Researchers also found that patients on afatinib experienced better quality of life. Afatinib is taken orally, which, according to the study’s lead author James Chih-Hsin Yang, MD, PhD, of the National Taiwan University Hospital, may require fewer visits to the doctor’s office as compared with the intravenous chemotherapy regimen. Also, the worsening of common lung cancer-related symptoms, such as coughing and shortness of breath, was delayed for those on afatinib compared with those receiving chemotherapy. Common side effects of afatinib included diarrhea, rash and mouth sores.

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
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