4/7/2024 0 Comments Different lung sounds![]() ![]() Osimertinib was effective in patients with brain metastasis, while afatinib demonstrated potential benefits in patients with the L858R mutation who did not have brain metastasis. A few real-world studies do not strongly favor osimertinib over afatinib in terms of longer median PFS and OS in first-line treatment. ![]() However, there have been no randomized controlled trials (RCTs) comparing second- and third-generation EGFR-TKIs. The new generation of EGFR-TKIs appears to offer better clinical efficacy than first-generation EGFR-TKIs. In the FLAURA study, first-line osimertinib treatment provided a clinically significant improvement in both PFS and OS compared to first-generation EGFR TKIs. Dacomitinib, another irreversible ErbB family blocker, significantly enhanced progression-free survival (PFS) compared to gefitinib in the first-line treatment of EGFR mutation-positive NSCLC patients. In the LUX-Lung 7 study, the irreversible ErbB family blocker afatinib notably improved results in EGFR-mutated NSCLC treatment-naive patients compared to gefitinib. In the case of first-generation EGFR-TKIs, several studies demonstrated that gefitinib and erlotinib had comparable efficacy, with gefitinib exhibiting a more favorable safety profile than erlotinib. The selection of these three generations of drugs as first-line treatment is an important issue. Third-generation EGFR-TKIs (osimertinib) treat T790M EGFR-mutant tumors, which represent the most common resistance mechanism, occurring in approximately 50% of patients who have used first- and second-generation EGFR-TKIs. Second-generation EGFR-TKIs (afatinib and dacominitib) form irreversible bonds with ErbB receptors, inhibiting signaling and offering an alternative for acquired resistance to first-generation TKIs. First-generation EGFR-TKIs (erlotinib and gefitinib) reversibly block ATP-binding sites, stopping downstream signaling. Three generations of EGFR-TKIs are available. Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have greatly improved the prognosis and quality of life for NSCLC patients with EGFR mutations, making them the first-line standard treatment over cytotoxic chemotherapy. These are known as sensitizing EGFR mutations. EGFR mutations, found in 30 to 50% of lung adenocarcinomas, commonly include exon 19 deletions (in 45% of patients) and the exon 21 L858R mutation (in 40% of patients). Studies show that patients with specific mutations in lung adenocarcinoma who receive matched targeted therapies experience longer overall survival (OS). Treatment strategies for advanced non-small cell lung cancer (NSCLC) are now personalized and guided by molecular tests. Lung cancer continues to be one of the most widespread and fatal cancers globally. Afatinib and dacomitinib can be safely administered to patients across different age groups with appropriate dose reductions. However, they have slightly different side effects. This study showed that afatinib and dacomitinib had similar effectiveness and safety profiles. 25.1 months, p = 0.152) were similar between patients younger than 75 years and those older than 75 years. 35.5%, p < 0.001), while the incidence of paronychia was higher in the dacomitinib group (58.1% vs. In terms of side effects, the incidence of diarrhea was higher in the afatinib group (75.8% vs. ![]() 19.6 months, p = 0.182) between patients receiving the standard dose and those receiving the reduced dose. There was no significant difference observed in the median PFS (16.1 vs. 15.9 months, p = 0.324) in patients with afatinib and dacomitinib treatment were similar. The median progression-free survival (PFS) (18.9 vs. The partial response rates (PR) for first-line treatment with afatinib and dacomitinib were 85.7 and 80.6% ( p = 0.522). ResultsĪ total of 101 patients were enrolled in the study (70 to afatinib and 31 to dacomitinib). The enrolled patients were assigned to two groups based on whether they received afatinib or dacomitinib. Materials and methodsīetween September 2020 and March 2023, we retrospectively recruited patients diagnosed with advanced-stage EGFR-mutant NSCLC who were treated with first-line irreversible EGFR-TKIs. We aimed to compare the efficacy and safety of afatinib and dacomitinib in this setting. The irreversible epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) afatinib and dacomitinib are approved for first-line treatment of EGFR mutation-positive non-small cell lung cancer (NSCLC). ![]()
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