Reactions 1680, p20 - 2 Dec 2017
Various toxicities: 24 case reports
In a retrospective observational study, 24 patients
(13 women and 11 men aged 44
82 years) were described,
out of which 7 patients developed skin rash, interstitial
pneumonitis, oral mucositis or paronychia during treatment
with afatinib while the 17 patients developed acquired
resistance to afatinib [routes and time to reactions onsets not
stated; not all dosages stated].
The patients, who were diagnosed with EGFR mutation-
positive lung adenocarcinoma, started receiving treatment
with afatinib. Seven out of the 17 patients received afatinib at a
dose 40 mg/day for total of 30
353 days and developed
treatment-related skin rash (3 patients), interstitial
pneumonitis (1 patient), skin rash and oral mucositis
(1 patient), oral mucositis (1 patient) and paronychia
(1 patient). Remaining 17 patients developed EGFR mutations
which included p.L858R and p.T790M (2 patients), p.E709K
and p.G719A (1 patient), 19DEL (7 patients), p.L858R
(5 patients), p.G719A (1 patient) and 20-INS (1 patient) with
MET amplifications detected by fluorescence in situ
hybridisation and immunohistochemistry. The development of
mutations indicated acquired resistance to afatinib.
In seven patients, the treatment with afatinib was
discontinued and was switched to gefitinib or erliotinib
[outcomes not stated].
Author comment: "Notably, 7 patients (5.0%)
discontinued afatinib treatment because of severe side effects.
In these patients, despite its clinical effectiveness, afatinib was
switched to gefitinib or erlotinib (Supplementary Table 1)."
"Seventeen of the 20 rebiopsy specimens were adequate for
MET immunohistochemical (IHC) staining (Supplementary
Table 4)." "Our findings confirmed that the p.T790M mutation
was the main mechanism of acquired resistance, followed by
Liang S-K, et al. Real-world experience of afatinib as a first-line therapy for
advanced EGFR mutation-positive lung adenocarcinoma. Oncotarget 8:
90430-90443, No. 52, 26 Jul 2017. Available from: URL: http://doi.org/10.18632/
oncotarget.19563 - Taiwan
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved