title: [Afatinib in patients with squamous cell carcinoma of the lung: current context and the option of oral treatment].
abstract: Squamous cell carcinoma (SCC) of the lung represents 30% of non-small cell lung cancers (NSCLC). Docetaxel and the EGFR tyrosine kinase inhibitor (TKI), erlotinib, are the only two drugs approved for second-line treatment of advanced SCC. The sensitivity of SCC to TKIs can be explained by EGFR overexpression. Erlotinib demonstrated a significant benefit in terms of overall survival (OS) in successive lines in NSCLC, including squamous histology. The magnitude of this benefit is similar to that of chemotherapy. Afatinib is an irreversible inhibitor of the entire ErbB family (EGFR, HER2-4) that has recently been approved for its current indication, advanced EGFR mutation-positive NSCLC and has well-defined and manageable toxicity, mainly gastrointestinal and cutaneous. The LUX-Lung 8 study was a phase III randomized trial in patients with NSCLC with squamous histology that compared erlotinib versus afatinib as second-line treatment. A total of 795 patients were included and a significant benefit was observed for afatinib in progression-free survival (2.7 vs 1.9 months (HR 0.79 [95%CI 0.68-0.91]; p=0.0012) and in OS (7.9 vs 6.8 months (HR 0.81 [95%CI 0.69-0.95]; p=0.0077), as well as a significant improvement in OS at 12 and 18 months. More diarrhoea and stomatitis was observed with afatinib and more rash with erlotinib, but the overall proportion of toxicity was similar in each group. Afatinib offered better results in quality of life. In summary, afatinib is a second-line treatment option in squamous NSCLC based on its survival advantage over erlotinib.
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España. Electronic address: manuelcobodols@yahoo.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Cobo
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Gutiérrez
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodelo
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España.
authors.forename: Omar
authors.initials: O
authors.lastname: López
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España.
authors.forename: María
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Málaga Regional y Virgen de la Victoria, Málaga, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Godoy
mesh_terms: D000284:Administration, Oral; D000077716:Afatinib; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000037:antagonists & inhibitors; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000235:genetics; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D018815:Genes, erbB; D005819:Genetic Markers; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D005819:Genetic Markers; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; D066246:ErbB Receptors
keywords: Advanced; Afatinib; Chemotherapy; Cáncer avanzado; Cáncer de pulmón; Cáncer epidermoide; Epidermoid; ErbB; Erlotinib; Lung cancer; Quimioterapia; Second line; Segunda línea