Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8) an open-label randomised controlled phase 3 trial /

Background There is a major unmet need for effective treatments in patients with squamous cell carcinoma of the lung. LUX-Lung 8 compared afatinib (an irreversible ErbB family blocker) with erlotinib (a reversible EGFR tyrosine kinase inhibitor), as second-line treatment for patients with advanced s...

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Elmentve itt :
Bibliográfiai részletek
Szerzők: Soria Jean-Charles
Felip Enriqueta
Cobo Manuel
Lu Shun
Syrigos Konstantinos
Lee Ki Hyeong
Goeker Erdem
Georgoulias Vassilis
Li Wei
Isla Dolores
Guclu Salih Z
Morabito Alessandro
Min Young J
Ardizzoni Andrea
Gadgeel Shirish M
Wang Bushi
Chand Vikram K
Goss Glenwood D
Kollaborációs szervezet: LUX-Lung 8 Investigators
Somfay Attila
et al
Dokumentumtípus: Cikk
Megjelent: 2015
Sorozat:LANCET ONCOLOGY 16 No. 8
Tárgyszavak:
doi:10.1016/S1470-2045(15)00006-6

mtmt:3410569
Online Access:http://publicatio.bibl.u-szeged.hu/29988
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245 1 0 |a Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8)  |h [elektronikus dokumentum] :  |b an open-label randomised controlled phase 3 trial /  |c  Soria Jean-Charles 
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490 0 |a LANCET ONCOLOGY  |v 16 No. 8 
520 3 |a Background There is a major unmet need for effective treatments in patients with squamous cell carcinoma of the lung. LUX-Lung 8 compared afatinib (an irreversible ErbB family blocker) with erlotinib (a reversible EGFR tyrosine kinase inhibitor), as second-line treatment for patients with advanced squamous cell carcinoma of the lung. Methods We did this open-label, phase 3 randomised controlled trial at 183 cancer centres in 23 countries worldwide. We enrolled adults with stage IIIB or IV squamous cell carcinoma of the lung who had progressed after at least four cycles of platinum-based-chemotherapy. Participants were randomly assigned (1:1) to receive afatinib (40 mg per day) or erlotinib (150 mg per day) until disease progression. The randomisation was done centrally with an interactive voice or web-based response system and stratified by ethnic origin (eastern Asian vs non-eastern Asian). Clinicians and patients were not masked to treatment allocation. The primary endpoint was progression-free survival assessed by independent central review (intention-to-treat population). The key secondary endpoint was overall survival. This trial is registered with ClinicalTrials.gov, NCT01523587. Findings 795 eligible patients were randomly assigned (398 to afatinib, 397 to erlotinib). Median follow-up at the time of the primary analysis of progression-free survival was 6.7 months (IQR 3.1-10.2), at which point enrolment was not complete. Progression free-survival at the primary analysis was significantly longer with afatinib than with erlotinib (median 2.4 months [95% CI 1.9-2.9] vs 1.9 months [1.9-2.2]; hazard ratio [HR] 0.82 [95% CI 0.68-1.00], p=0.0427). At the time of the primary analysis of overall survival (median follow-up 18.4 months [IQR 13.8-22.4]), overall survival was significantly greater in the afatinib group than in the erloinib group (median 7.9 months [95% CI 7.2-8.7] vs 6.8 months [5.9-7.8]; HR 0.81 [95% CI 0.69-0.95], p=0.0077), as were progression-free survival (median 2.6 months [95% CI 2.0-2.9] vs 1.9 months [1.9-2.1]; HR 0.81 [95% CI 0.69-0.96], p=0.0103) and disease control (201 [51%] of 398 patients vs 157 [40%] of 397; p=0.0020). The proportion of patients with an objective response did not diff er signifi cantly between groups (22 [6%] vs 11 [3%]; p=0.0551). Tumour shrinkage occurred in 103 (26%) of 398 patients versus 90 (23%) of 397 patients. Adverse event profiles were similar in each group: 224 (57%) of 392 patients in the afatinib group versus 227 (57%) of 395 in the erlotinib group had grade 3 or higher adverse events. We recorded higher incidences of treatment-related grade 3 diarrhoea with afatinib (39 [10%] vs nine [2%]), of grade 3 stomatitis with afatinib (16 [4%] vs none), and of grade 3 rash or acne with erlotinib (23 [6%] vs 41 [10%]). Interpretation The signifi cant improvements in progression-free survival and overall survival with afatinib compared with erlotinib, along with a manageable safety profile and the convenience of oral administration suggest that afatinib could be an additional option for the treatment of patients with squamous cell carcinoma of the lung. 
650 4 |a Klinikai orvostan 
700 0 1 |a Felip Enriqueta  |e aut 
700 0 1 |a Cobo Manuel  |e aut 
700 0 1 |a Lu Shun  |e aut 
700 0 1 |a Syrigos Konstantinos  |e aut 
700 0 1 |a Lee Ki Hyeong  |e aut 
700 0 1 |a Goeker Erdem  |e aut 
700 0 1 |a Georgoulias Vassilis  |e aut 
700 0 1 |a Li Wei  |e aut 
700 0 1 |a Isla Dolores  |e aut 
700 0 1 |a Guclu Salih Z  |e aut 
700 0 1 |a Morabito Alessandro  |e aut 
700 0 1 |a Min Young J  |e aut 
700 0 1 |a Ardizzoni Andrea  |e aut 
700 0 1 |a Gadgeel Shirish M  |e aut 
700 0 1 |a Wang Bushi  |e aut 
700 0 1 |a Chand Vikram K  |e aut 
700 0 1 |a Goss Glenwood D  |e aut 
700 0 2 |a Kollaborációs szervezet: LUX-Lung 8 Investigators  |e aut 
700 0 2 |a Somfay Attila  |e aut 
700 0 2 |a et al.  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/29988/1/1-s2.0-S1470204515000066-main.pdf  |z Dokumentum-elérés