2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12A.18 Afatinib vs. Osimertinib as First-Line Treatment for Metastatic Non-Small Cell Lung Cancer Harboring EGFR Mutations

EP.12A.18 Afatinib vs. Osimertinib as First-Line Treatment for Metastatic Non-Small Cell Lung Cancer Harboring EGFR Mutations

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This study evaluates the effectiveness and safety of two treatments, afatinib and osimertinib, as first-line therapies for metastatic non-small cell lung cancer (NSCLC) with EGFR mutations in Vietnamese patients. Due to high costs and limited accessibility, osimertinib's usage in Vietnam is restricted, while afatinib provides a durable survival benefit with manageable side effects. This retrospective study compares their survival outcomes without a head-to-head comparison available yet.<br /><br />The study was conducted at the Ho Chi Minh City Oncology Hospital and involved 156 patients between 2018 and 2022. Participants included those with stage IIIB/IV NSCLC, having EGFR mutations, and who were treatment-naïve to EGFR TKIs. The results show there was no significant difference in time on treatment (TOT) between afatinib (18.6 months) and osimertinib (16.1 months). Survival rates at 12 months were 88% for afatinib and 82% for osimertinib, indicating a non-superiority of osimertinib over afatinib in prolonging survival.<br /><br />Regarding side effects, afatinib frequently resulted in rash/acne (41%), diarrhea (34%), and stomatitis (26%), while osimertinib most commonly caused rash/acne (38%) and diarrhea (30%), with four cases of mild interstitial lung disease. Overall, both treatments were generally tolerated well, with afatinib showing fewer severe side effects compared to previous reports.<br /><br />The findings suggest that both drugs offer comparable efficacy in first-line treatment of EGFR-mutant NSCLC in Vietnamese patients. However, due to limited accessibility to osimertinib, afatinib could be a viable alternative. Further large-scale prospective studies are needed to determine the best treatment approach for Asian patients with EGFR mutation-positive NSCLC.

Asset Subtitle

Thu Hoang

Meta Tag

Speaker Thu Hoang

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

afatinib

osimertinib

NSCLC

EGFR mutations

Vietnamese patients

survival outcomes

side effects

first-line therapy

treatment accessibility

retrospective study