Clinical Research Papers:

Prognostic factors of afatinib as a first-line therapy for advanced EGFR mutation-positive lung adenocarcinoma: a real-world, large cohort study

Sheng-Kai Liang, Meng-Rui Lee, Wei-Yu Liao, Chao-Chi Ho, Jen-Chung Ko and Jin-Yuan Shih _

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Oncotarget. 2018; 9:23749-23760. https://doi.org/10.18632/oncotarget.25255

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Sheng-Kai Liang1,2, Meng-Rui Lee1, Wei-Yu Liao3, Chao-Chi Ho3, Jen-Chung Ko1 and Jin-Yuan Shih3

1Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan

2Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan

3Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence to:

Jin-Yuan Shih, email: [email protected]

Keywords: afatinib; EGFR mutation-positive lung adenocarcinoma; prognostic factor; first-line therapy; real-world study

Received: December 26, 2017    Accepted: April 07, 2018    Published: May 04, 2018


Lung cancer remains the primary cause of cancer-related mortality worldwide. Several treatment modalities are available for lung cancer, including surgery, radiation, and chemotherapy. Among the chemotherapeutics available, afatinib has been shown to be effective for those with epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma. Herein, we analyzed the factors affecting the prognosis of patients who received afatinib as a first-line therapy for advanced EGFR mutation-positive lung adenocarcinoma in the real-world setting. Patients who received afatinib as a first-line therapy and were reimbursed by the National Health Insurance were recruited in this study. Data on patient characteristics and treatment courses were collected. In total, 259 patients were enrolled (median follow-up, 22.0 months). Of them, 82 (31.7%) were identified to have brain metastases at baseline, which were associated with poor Eastern Cooperative Oncology Group performance status, high incidence of central nervous system progression, and short overall survival. However, the results of our analysis showed that overall survival was not affected by reductions in the afatinib dosage or any upfront local treatments for brain tumors. Multivariate analyses showed that brain metastases at diagnosis and treatment response to afatinib are two important prognostic factors for the overall survival of patients with EGFR mutation-positive lung adenocarcinoma.

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