Department of Neurology, Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
J Int Med Res. 2020 Aug;48(8):300060520937093. doi: 10.1177/0300060520937093.
To evaluate survival following afatinib (AF) and erlotinib (ER) treatment in advanced del19 lung adenocarcinoma (AD19LA) with asymptomatic brain metastasis (ABM) after pemetrexed-cisplatin chemotherapy (PCC).
Data were retrospectively analysed from individuals with AD19LA and ABM after PCC who received AF or ER for 2 years or until intolerable adverse events (AEs), withdrawal, or death. The primary outcome was survival; secondary outcomes were AEs.
The final analysis included 174 AD19LA individuals (AF: n = 86; ER: n = 88) with a median follow-up of 24.2 months (IQR 2.1-28.3). Significant differences in overall survival (16.2 months [95%CI 15.4-17.1] for AF vs 7.2 months [95%CI 6.3-8.1] for ER) (HR 0.50, 95%CI 0.36-0.71, p<0.0001) and median progression-free survival (9.4 months [95%CI 8.5-9.7] for AF vs 5.6 months [4.7-6.2] for ER) (HR 0.66, 95%CI 0.47-0.94, p=0.02) were observed between the groups. Rates of all-grade AEs were 82.5% for AF and 72.7% for ER, and rates of grade ≥3 AEs were 37.2% for AF and 34.0% for ER.
Compared with ER, AF treatment may be more beneficial in terms of survival in the management of AD19LA after PCC with a tolerable safety profile.
评估培美曲塞顺铂化疗（PCC）后无症状脑转移（ABM）的晚期 del19 肺腺癌（AD19LA）患者接受阿法替尼（AF）和厄洛替尼（ER）治疗后的生存情况。
回顾性分析接受 AF 或 ER 治疗 2 年或直至不可耐受的不良反应（AE）、退出或死亡的 PCC 后发生 AD19LA 合并 ABM 的患者数据。主要结局为生存情况；次要结局为 AE。
最终分析纳入 174 例 AD19LA 患者（AF：n=86；ER：n=88），中位随访时间为 24.2 个月（IQR：2.1-28.3）。AF 的总生存（16.2 个月[95%CI：15.4-17.1]）显著长于 ER（7.2 个月[95%CI：6.3-8.1]）（HR：0.50，95%CI：0.36-0.71，p<0.0001），中位无进展生存（9.4 个月[95%CI：8.5-9.7]）也显著长于 ER（5.6 个月[4.7-6.2]）（HR：0.66，95%CI：0.47-0.94，p=0.02）。AF 组和 ER 组的所有级别 AE 发生率分别为 82.5%和 72.7%，≥3 级 AE 发生率分别为 37.2%和 34.0%。
与 ER 相比，AF 治疗可能更有益于 PCC 后 AD19LA 合并 ABM 的管理，具有可耐受的安全性。
