WCLC 2025 - Posters & ePosters-EP.12.21 The Impact of Afatinib and Osimertinib Plasma Concentrations on Treatment Toxicities, Quality of Life, and Effectiveness in Patients With NSCLC

EP.12.21 The Impact of Afatinib and Osimertinib Plasma Concentrations on Treatment Toxicities, Quality of Life, and Effectiveness in Patients With NSCLC

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This prospective study investigated how plasma concentrations of the EGFR-tyrosine kinase inhibitors afatinib and osimertinib influence treatment toxicities, quality of life (QoL), and effectiveness in patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC). Forty-five treatment-naïve NSCLC patients (25 on afatinib, 20 on osimertinib) were enrolled. Plasma drug levels were measured at two weeks using liquid chromatography-tandem mass spectrometry, with treatment-related toxicities and QoL assessed at weeks two and four. <br /><br />Findings highlighted a non-significant negative trend between plasma concentration and body mass index (BMI). For afatinib, higher plasma concentrations were significantly associated with increased dermatology life quality index scores and greater use of anti-diarrhea medications, indicating heightened toxicity. In osimertinib-treated patients, elevated plasma levels significantly correlated with worsened physical and social functioning on QoL measures. Notably, higher osimertinib concentrations also corresponded to longer progression-free survival, demonstrating enhanced treatment effectiveness.<br /><br />These results reveal that plasma concentrations of afatinib and osimertinib impact both toxicity profiles and patient QoL, as well as treatment outcomes in NSCLC. The study suggests that therapeutic drug monitoring (TDM) could be a valuable tool in optimizing dosing strategies for these targeted therapies, balancing minimizing adverse effects with maximizing efficacy. By adjusting doses based on plasma drug levels, clinicians may be better able to tailor treatment to individual patients, improving tolerability and clinical benefits in the management of EGFR-mutated NSCLC.

Asset Subtitle

Sheng-Kai Liang

Meta Tag

Speaker Sheng-Kai Liang

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

EGFR-tyrosine kinase inhibitors

afatinib

osimertinib

non-small cell lung cancer

plasma drug concentration

treatment toxicity

quality of life

therapeutic drug monitoring

progression-free survival

dose optimization