Kết quả điều trị bệnh nhân ung thư phổi không tế bào nhỏ giai đoạn tiến xa có đột biến gen EGFR bằng afatinib

To evaluate the result of afatinib as a first line therapy in advanced stage non-small cell lung cancer patients who have EGFR mutations positive. Subject and method: This was a prospective study, 41 patients with advanced stage non-small cell lung cancer with EGFR positive mutations were treated by afatinib as a first line treatment, they were followed and evaluated every 3 months or when they have symptoms of progressive disease. The main endpoints were the Objective Response Rate (ORR) and Progression-Free Survival (PFS), the secondary endpoints were Overall survival (OS) and adverse events. Result: The ORR was 92.6%, the median PFS was 14 months, and the median OS was 20 months. The estimated 1-year and 2-year OS rates were 93.3% and 39.1%, respectively. Median PFS in patients without brain metastases was 14 months, longer than in patients with brain metastases (12 months), p>0.05. Median PFS in patients harboring activating EGFR mutations was 14 months, longer than in patients with uncommon mutations (11 months), p>0.05; Median OS in patients carrying the exon 19 deletion mutation was 32 months, longer than the median OS in patients with EGFR mutation of L858R and uncommon mutations at 20 months and 17 months, respectively, p>0.05. Adverse effects were seen in 82.9% of patients, mainly rash (80.5%), but all of them were grade 1, grade 2. 5% of patients had grade 3 diarrhea. Conclusion: Afatinib was an effective option to treatment in patients with advanced stage non-small cell lung cancer with EGFR mutations. Especially, overall survival tended to be longer in patients carrying exon 19 deletion mutation compare L858R mutation and uncommon mutations.