Efficacy of Combination Therapy with Osimertinib and Afatinib in epidermal growth factor receptor-mutant non-small-cell lung cancer Patients

Year : 2024 | Volume :13 | Issue : 01 | Page : 13-24
By

    Tshetiz Dahal

  1. Bonish Raj Subedi

  1. Clinical Researcher, Lugansk State Medical University, Lypnia, Ukraine
  2. Medical Officer, Kathmandu University, , Nepal

Abstract

Treatment options for patients with non-small-cell lung cancer who have epidermal growth factor receptor mutations are constrained by the emergence of resistance to epidermal growth factor receptor tyrosine kinase inhibitors. Osimertinib or afatinib alone, when tested in a laboratory model, led to the formation of drug-resistant clones harboring epidermal growth factor receptor secondary mutations. However, combining these drugs prevented the emergence of such mutations. In a Phase II clinical trial, we investigated the efficacy of alternating-dose therapy involving Osimertinib and afatinib in patients diagnosed with epidermal growth factor receptor-mutant non-small-cell lung cancer. Eligible participants included individuals with stage IV non-small-cell lung cancer carrying an activating epidermal growth factor receptor mutation who had not previously undergone treatment. Every eight weeks, Osimertinib (80 mg/day) and afatinib (20 mg/day) were given in alternate cycles. Genomic analysis was carried out by utilizing circulating tumors DNA collected both before and after therapy. The median duration of progression-free survival for the 50 patients who participated in the study was 21.3 months. A total of 70.3% of respondents responded. Overall median survival was not attained. About 35 plasma samples were acquired after the development of resistance; five of these samples displayed an elevated MET gene copy number and three displayed a BRAF mutation. However, no secondary epidermal growth factor receptor mutation was found. The effectiveness of our approach was comparable to that of Osimertinib alone, as had been observed in untreated advanced non-small-cell lung cancer patients with epidermal growth factor receptor mutations in the past. The treatment may stop the emergence of epidermal growth factor receptor secondary mutations that lead to medication resistance, despite the small sample size. To determine the importance of this treatment, more research is required

Keywords: non-small-cell lung cancer, mutation, BRAF mutation, secondary epidermal growth factor receptor mutation, efficacy, clinical trial, treatment strategy, medication resistance

[This article belongs to Research & Reviews: Journal of Oncology and Hematology(rrjooh)]

How to cite this article: Tshetiz Dahal, Bonish Raj Subedi.Efficacy of Combination Therapy with Osimertinib and Afatinib in epidermal growth factor receptor-mutant non-small-cell lung cancer Patients.Research & Reviews: Journal of Oncology and Hematology.2024; 13(01):13-24.
How to cite this URL: Tshetiz Dahal, Bonish Raj Subedi , Efficacy of Combination Therapy with Osimertinib and Afatinib in epidermal growth factor receptor-mutant non-small-cell lung cancer Patients rrjooh 2024 {cited 2024 Apr 20};13:13-24. Available from: https://journals.stmjournals.com/rrjooh/article=2024/view=143782


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Regular Issue Subscription Review Article
Volume 13
Issue 01
Received January 22, 2024
Accepted January 31, 2024
Published April 20, 2024
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