[Adverse events of afatinib as first-line treatment for five cases of advanced lung adenocarcinoma and review of literature].
OBJECTIVE
Afatinib is an irreversible ErbB-family blocker with a clinical activity in non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutations. The aim of this study is to assess the safety of afatinib in patients with advanced lung adenocarcinoma.


METHODS
Patients with lung adenocarcinoma (stage IIIb or IV) with EGFR mutations were first-line treated with an oral administration of afatinib (40 mg/d) until disease progression. Adverse events, effects, and survival condition were observed.


RESULTS
The most common adverse events were diarrhea (n=5, 100%), skin rash (n=4, 80%), and mucositis/stomatitis (n=4, 80%). Moderate toxicities not exceeding grade 3 were observed. Relatively, the most serious adverse reaction was mucositis/stomatitis. Mild diarrhea occurred in all patients. Three patients experienced temporary drug withdrawal and dose reduction because of adverse reaction. Among the four patients who were evaluated, partial response was observed in two patients (50%), one with stable disease (25%) and one with progressive disease (25%). Median progression-free survival was 9.7 months, whereas median overall survival was 18.4 months.


CONCLUSIONS
Afatinib was approved as first-line treatment for patients with advanced lung adenocarcinoma. The most common adverse events were diarrhea and skin rash. However, mucositis/stomatitis related to afatinib should also be considered. Considering the small number of cases, the conclusion requires more trials for confirmation.
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Hong
H
Tao
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Lili
L
Guo
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Junfang
J
Tang
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Yunzhong
Y
Zhu
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Liyan
L
Xu
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Qiyi
Q
Meng
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Wei
W
Wu
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Mingzhi
M
Li
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Weihua
W
Wu
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Li
L
Tong
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Hongbo
H
Wu
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Liang
L
Shi
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Zhe
Z
Liu
D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy*; D000077192:Adenocarcinoma of Lung; D000077716:Afatinib; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005076:Exanthema / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D013280:Stomatitis / Q000453:epidemiology / Q000209:etiology
D000970:Antineoplastic Agents; D011799:Quinazolines; D000077716:Afatinib