Novel Therapy Slows Lung Adenocarcinoma Relapse

Afatinib shows promise as a treatment for patients with advanced lung adenocarcinomas who tested positive for EGFR mutations.

In a study of 354 patients with stage IIIB or IV non-small cell lung cancer (NSCLC) who had mutations in the gene for the epidermal growth factor receptor (EGFR), a new investigational tyrosine kinase inhibitor called afatinib successfully delayed disease relapse for nearly a year in some participants.

The results of the phase III trial, which were recently released at the annual meeting of the American Society of Clinical Oncology (ASCO), suggest that afatinib is more effective than standard chemotherapy with cisplatin (Platin) and pemetrexed (Alimta) in the treatment of lung adenocarcinoma.

The median progression-free survival rate for those on afatinib was 8 months, whereas the median rate for those of chemotherapy was just 6.9 months. Among patients with deletion 19 and L85L8R, the most common EGFR mutations, the time before relapse was even higher in the afatinib group than in the chemotherapy group —13.6 vs. 6.9 months, respectively.

The most important outcome of the trials was that patients experienced an improved clinical benefit, with fewer reported symptoms of cough, chest pain, and shortness of breath. In addition, afatinib appeared to delay onset of these symptoms.

“Based on this proven efficacy in the largest and most robust registration trial, coupled with its novel mode of action, afatinib may become one of the most valuable treatment options for this distinct patient population,” said lead investigator James Chih-Hsin Yang, MD, PhD, professor and director of cancer research at the National Taiwan University in Taipei, in a press release.

Afatinib is different than currently available targeted therapies in that it “irreversibly blocks the ErbB Family of receptors, meaning afatinib blocks EGFR (ErbB1) as well as the other relevant members of the ErbB Family,” according to the press release. When the drug binds to EGFR, it is irreversible. This mechanism is unlike that of the existing tyrosine kinase inhibitors approved to target EGFR mutations, such as gefitinib (Iressa) or erlotinib (Tarceva).

Yang noted that 7.9% of afatinib patients dropped out because of toxicity, compared with 11.7% of those in the chemotherapy arm. The drug is rumored to be approved as a first-line therapy for disease with EGFR-mutated non-small cell lung cancer.