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Review
. 2018 Jan 24:11:529-538.
doi: 10.2147/OTT.S136579. eCollection 2018.

Clinical efficacy and safety of afatinib in the treatment of non-small-cell lung cancer in Chinese patients

Lei-Yun Wang  1   2 , Jia-Jia Cui  1   2 , Ao-Xiang Guo  1   2 , Ji-Ye Yin  1   2
Affiliations
Review

Clinical efficacy and safety of afatinib in the treatment of non-small-cell lung cancer in Chinese patients

Lei-Yun Wang et al. Onco Targets Ther. .

Abstract

Compared with various malignant tumors, lung cancer has high incidence and the highest mortality worldwide. Non-small-cell lung cancer (NSCLC), the most common kind of lung cancer, is still a great threat to the world, including China. Surgery, platinum-based chemotherapy, and radiotherapy are still the primary treatments for NSCLC patients in the clinic, whereas immunotherapy and targeted therapy are gradually playing more important roles. A next-generation tyrosine kinase inhibitor (TKI), afatinib, was developed as a targeted reagent for epidermal growth factor receptor (EGFR). This targeted drug was effective in a series of trials. The US Food and Drug Administration then approved afatinib as a new first-line treatment for EGFR L858R and exon 19 deletion mutant patients in 2013. This review focused on current clinical studies of afatinib. Although this TKI was not widely available in China until recently, we aim to provide a reference for its future use in China.

Keywords: Chinese patients; NSCLC; afatinib; companion diagnosis; drug resistance; side effect.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Signaling pathways of EGFR and HER2. Notes: Pathways downstream of EGFR and HER2 are presented in this figure. Afatinib can inhibit these pathways which facilitate cancer cell survival through inhibiting EGFR and HER2 directly. L indicates the ligands that have the ability to activate the EGFR such as EGF and TGF-α. Abbreviations: AKT, serine/threonine kinase; EGF, epidermal growth factor; EGFR, epidermal growth factor receptor; HER2, human epidermal growth factor receptor 2; PI3K, phosphatidylinositol 3 kinase; TGF-α, transforming growth factor-α.
Figure 2
Figure 2
The difference of efficacy and safety between Chinese and non-Chinese patients. Notes: Red refers to Chinese patients, whereas black refers to non-Chinese patients. (A) The PFS period of Chinese and non-Chinese NSCLC patients are presented. The hollow triangle indicates data without 95% CI value. (B) The adverse events rate in Chinese and non-Chinese NSCLC patients are presented. Abbreviations: CI, confidence interval; NA, not applicable; NSCLC, non-small-cell lung cancer; PFS, progression-free survival.
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