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Afatinib and Cetuximab in Four Patients With EGFR Exon 20 Insertion-Positive Advanced NSCLC.
- Source :
-
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2018 Aug; Vol. 13 (8), pp. 1222-1226. Date of Electronic Publication: 2018 Apr 24. - Publication Year :
- 2018
-
Abstract
- Introduction: EGFR exon 20 insertions comprise 4% to 9% of EGFR mutated NSCLC. Despite being an oncogenic driver, they are associated with primary resistance to EGFR tyrosine kinase inhibitors (TKIs). We hypothesized that dual EGFR blockade with afatinib, an irreversible EGFR TKI, and cetuximab, a monoclonal antibody against EGFR, could induce tumor responses.<br />Methods: Four patients with EGFR exon 20 insertion-positive NSCLC were treated with afatinib 40 mg once daily and cetuximab 250 mg/m <superscript>2</superscript> to 500 mg/m <superscript>2</superscript> every 2 weeks.<br />Results: All patients had stage IV adenocarcinoma of the lung harboring an EGFR exon 20 insertion mutation. Previous lines of treatment consisted of platinum doublet chemotherapy (n = 4) and EGFR TKI (n = 2). Three of four patients showed a partial response according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Median progression-free survival was 5.4 months (95% confidence interval: 0.0 - 14.2 months; range 2.7 months - 17.6 months). Toxicity was manageable with appropriate skin management and dose reduction being required in two patients.<br />Conclusions: Dual EGFR blockade with afatinib and cetuximab may induce tumor responses in patients with EGFR exon 20 insertion-positive NSCLC.<br /> (Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma of Lung pathology
ErbB Receptors genetics
Exons
Female
Humans
Lung Neoplasms pathology
Male
Adenocarcinoma of Lung drug therapy
Adenocarcinoma of Lung genetics
Afatinib therapeutic use
Antineoplastic Agents, Immunological therapeutic use
Cetuximab therapeutic use
Lung Neoplasms drug therapy
Lung Neoplasms genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1556-1380
- Volume :
- 13
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 29702285
- Full Text :
- https://doi.org/10.1016/j.jtho.2018.04.012