Evidence map›Paper›PMID 32559335›Full record

Trial reportThe oncologist2020

Phase II Study of Low-Dose Afatinib Maintenance Treatment Among Patients with EGFR-Mutated Non-Small Cell Lung Cancer: North Japan Lung Cancer Study Group Trial 1601 (NJLCG1601).

Atsushi Nakamura, Hisashi Tanaka, Ryota Saito, Aya Suzuki, Toshiyuki Harada, Sumito Inoue, Toru Yamada, Taku Nakagawa, Daisuke Jingu, Shunichi Sugawara

Abstract readClinical Trial, Phase II
In one paragraph

Trial report in The oncologist, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Metabolic complete tumor response in a patient withThe Journal of international medical research · 2022
    Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Atsushi NakamuraDepartment of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan.
Hisashi TanakaDepartment of Respiratory Medicine, Hirosaki University, Hirosaki, Japan.
Ryota SaitoDepartment of Respiratory Medicine, Tohoku University Hospital, Sendai, Japan.
Aya SuzukiDepartment of Respiratory Medicine, Miyagi Cancer Center, Natori, Japan.
Toshiyuki HaradaDepartment of Respiratory Medicine, JCHO Hokkaido Hospital, Sapporo, Japan.
Sumito InoueDepartment of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Toru YamadaFirst Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Taku NakagawaDapartment of Thoracic Surgery, Omagari Kosei Medical Center, Daisen, Japan.
Daisuke JinguDepartment of Respiratory Medicine, Saka General Hospital, Shiogama, Japan.
Shunichi SugawaraDepartment of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

lessons learnedLow-dose afatinib maintenance treatment among patients with EGFR-mutated NSCLC achieved long-time to treatment failure with fewer treatment-related AEs without detracting from the therapeutic efficacy. This modified regimen represents a practical usage that balances effectiveness and safety.

backgroundAlthough afatinib is an effective therapy for patients with EGFR-mutated non-small cell lung cancer (NSCLC), drug-related adverse events (AEs) have often necessitated dose reductions. In a post hoc analysis of the LUX-Lung 3 and 6 trials, there was no difference in median progression-free survival (PFS) between patients who had the dose of afatinib reduced and those who did not. We thus evaluated the efficacy and tolerability of low-dose afatinib maintenance treatment among patients with NSCLC harboring EGFR mutations who had not been previously treated.

methodsEligible patients received afatinib 40 mg orally once daily. When prescribed grade ≥ 2 AEs, rash of grade ≥ 3, or unacceptable toxicity occurred, the afatinib dose was reduced from 40 to 30 mg and if needed from 30 to 20 mg. The primary endpoint was the 1-year PFS rate. Secondary endpoints were PFS, overall response rate (ORR), and toxicity.

resultsAmong 30 patients, 93% had adenocarcinoma, 53% had exon 19 deletion, 37% had L858R, and 10% had minor mutations. The 1-year PFS rate was 50% (95% confidence interval [CI], 31.3-66.1) and the median PFS was 11.8 months (95% CI, 7.1-21.4). The incidence rate of grade ≥ 3 toxicities was 57%, including elevated aspartate aminotransferase/alanine aminotransferase level (13%), diarrhea (10%), and paronychia (10%).

conclusionLow-dose afatinib maintenance treatment reduced treatment-related AEs without detracting from the therapeutic efficacy.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAfatinibErbB ReceptorsHumansJapanMutationProtein Kinase InhibitorsQuinazolinesTreatment OutcomeAfatinibEGFR protein, humanErbB ReceptorsProtein Kinase InhibitorsQuinazolines

Identifiers

PMID32559335
PMCPMC7543297

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.