Evidence map›Paper›PMID 41673455›Full record

ArticleScientific reports2026

Efficacy and safety findings of the EXTRA study in older adult EGFR-mutant lung cancer patients receiving afatinib as first-line treatment.

Kei Morikawa, Saori Takata, Hisashi Tanaka, Hidetoshi Itani, Masashi Ishihara, Kazuya Horiuchi, Yasuhiro Kato, Shinnosuke Ikemura, Hideyuki Nakagawa, Yoshiro Nakahara and 21 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

31 authors.

Kei MorikawaDepartment of Respiratory Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Saori TakataDepartment of Respiratory Medicine, Kyorin University, Tokyo, Japan.
Hisashi TanakaDepartment of Respiratory Medicine, Hirosaki University, Aomori, Japan.
Hidetoshi ItaniDepartment of Respiratory Medicine, Japanese Red Cross Ise Hospital, Mie, Japan.
Masashi IshiharaDivision of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Kazuya HoriuchiRespiratory Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
Yasuhiro KatoDepartments of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan.
Shinnosuke IkemuraDivision of Pulmonary Medicine, Keio University Hospital, Tokyo, Japan.
Hideyuki NakagawaDepartment of Respiratory Medicine, National Hospital Organization, Hirosaki Hospital, Aomori, Japan.
Yoshiro NakaharaDepartment of Respiratory Medicine, Kitasato University School of Medicine, Kanagawa, Japan.
Yoshitaka SekiDepartment of Internal Medicine, The Jikei University Daisan Hospital, Tokyo, Japan.
Akihiro BesshoDepartment of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan.
Nobumasa TakahashiDepartment of General Thoracic Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
Kentaro HayashiDivision of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Takeo EndohNational Hospital Organization Mito Medical Center, Ibaraki, Japan.
Kiyoshi TakeyamaDepartment of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Toshiya MaekuraDepartment of Respiratory Medicine, Hoshigaoka Medical Center, Osaka, Japan.
Nagio TakigawaDepartment of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan.
Akikazu KawaseFirst Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
Makoto EndohDepartment of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Kenji NemotoDepartment of Respiratory Medicine, National Hospital Organization, Ibarakihigashi National Hospital, Ibaraki, Japan.
Kazuma KishiDepartment of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.
Kenzo SoejimaClinical and Translational Research Center, Keio University Hospital, Tokyo, Japan.
Yusuke OkumaDepartments of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Kenichi YoshimuraMedical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
Daisuke SaigusaLaboratory of Biomedical and Analytical Sciences, Faculty of Pharmaceutical Sciences, Teikyo University, Tokyo, Japan.
Yae KanaiDepartment of Pathology, Keio University School of Medicine, Tokyo, Japan.
Koji UedaDivision of Analytical Biochemistry, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, Tokyo, Japan.
Akira TogashiNippon Boehringer Ingelheim Co., Ltd., Tokyo, Japan.
Noriyuki MatsutaniDepartment of Surgery, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
Nobuhiko SekiDivision of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan. nseki@med.teikyo-u.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The EXTRA trial was the first to identify predictive biomarkers for afatinib efficacy in epidermal growth factor receptor (EGFR)-mutant NSCLC. We analyzed the clinical data of older adult patients before translational analysis. This prospective study involved untreated patients with EGFR-mutant NSCLC who received afatinib at an initial dose of 40 mg/day, followed by stepwise dose reductions, ultimately reaching 20 mg administered every other day. Treatment efficacy and adverse events (AEs) were compared between non-older and older adult patients. Among the 103 patients, 71 were aged < 75 years, and 32 were aged ≥ 75 years. Despite increased dose reductions in the older adults, progression-free survival was comparable: 21.5 vs. 18.6 months for non-older and older adults, respectively. The median overall survival (OS) was not reached in either group; the 2-year OS rates were 82% and 75% in non-older and older adults, respectively. Median post-progression survival in patients administered second-line drug therapy was 14.3 and 11.2 months in non-older (n = 42) and older adults (n = 20), respectively. Among older adults, 31 (97%) patients experienced AEs of all grades, and only six patients had grade ≥ 3 AEs with no grade 5 AEs. Afatinib demonstrated comparable therapeutic efficacy and safety in older and non-older adult patients with advanced EGFR-mutant NSCLC.Trial registration: UMIN-CTR identifier (UMIN000024935).

Indexed as

AfatinibAntineoplastic AgentsCarcinoma, Non-Small-Cell LungLung NeoplasmsMutationProtein Kinase InhibitorsAdultAgedAged, 80 and overErbB ReceptorsFemaleHumansMaleMiddle AgedProgression-Free SurvivalProspective StudiesAfatinibAntineoplastic AgentsEGFR protein, humanErbB ReceptorsProtein Kinase InhibitorsAfatinibEGFR-TKIElderly patientNon-small-cell lung cancer (NSCLC)

Identifiers

PMID41673455
PMCPMC12966495

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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.