stefano
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Posts:10
Is there a general protocol for treatment, by its self or are oncologists looking to combine Aftinib with our treatments? IE is it thought to replace Tarceva and Alimta or be combined with one or the other?
Stefano
3.8 monthe stage 4 NSCLC
Primary Tarceva, added Alimta 9 monthes ago.
Not mets( known at this time) outside of lungs
Forums
Reply # - July 24, 2013, 01:50 PM
Reply To: Aftinib treatment
Following is a link to a host of blog posts on the subject, http://cancergrace.org/lung/tag/afatinib/
In the first and latest post on EGFR TKIs Dr. West expresses concerns including, "I have long been critical about afatinib, the “irreversible pan-HER inhibitor” from Boehringer-Ingelheim (BI) that is poised as a next generation EGFR inhibitor but actually has no real evidence that it’s more than a more toxic version of Tarceva or Iressa (gefitinib) as first line therapy for patients with an activating EGFR mutation and advanced NSCLC, with no clear added benefit. However, the LUX Lung 3 trial was conducted to conform to FDA gamesmanship and obtain a first line approval, and we anticipate that BI will win that approval. I have historically favored Tarceva because I see no evidence of greater benefit but worse side effects with afatinib, and unless mandated by payers, I don’t think we should reward gamesmanship that is about marketing rather than science. " http://cancergrace.org/lung/2013/05/17/first-line-tarceva-egfr-mutation…
With approval by the FDA this discussion ensued. http://cancergrace.org/topic/afatinib-approved-by-fda
There is much more written on the subject and can be found by using our search feature. Note you may need to log off to access results depending on your browser. Here are results from "afatinib" http://cancergrace.org/search-results?q=afatinib
Please don't hesitate to ask for more clarification after browsing.
Much good luck,
Janine
forum moderator
Reply # - July 24, 2013, 09:27 PM
Reply To: Aftinib treatment
At this moment, afatinib is approved only as first line therapy for patients with an activating EGFR mutation. There is no evidence that it's better than Tarceva or Iressa in this regard.
There is no evidence that afatinib has any significant activity in EGFR mutation-positive patients who developed acquired resistance to another EGFR inhibitor previously. It has been shown to improve progression-free survival for a few months, but overall survival was actually a little longer in the recipients of placebo vs. afatinib in these people who already received an EGFR inhibitor.
It's possible that afatinib/cetuximab is superior in this setting, but it's not approved or well studied for acquired resistance to EGFR TKIs. It's not standard, not approved, and not clearly indicated outside of a trial setting right now. And there's essentially no study of afatinib in combination with chemo.
-Dr. West