The choice of a first-line
therapy for
lung cancer is a crucial decision that can impact the survival as well as the quality of life of a patient. Inhibitors of
epidermal growth factor receptor (EGFR) such as
afatinib,
erlotinib, and
gefitinib have previously been used to treat
non-small cell lung cancer harboring favorable EGFR mutations. Although
afatinib has greater efficacy than other EGFR inhibitors, adverse events related to its use can result in the discontinuation of the
therapy. In this study, we compared the therapeutic efficacy in
lung cancer patients of a regimen of 40 mg/day of
afatinib with that of a lower dose regimen of <40 mg/day resulting either from a lower starting dose of 30 mg/day or dose adjustment. Seventy-nine patients were treated with 40 mg/day and 67 received de-escalated doses of <40 mg/day. There was no significant difference in the clinical characteristics of the two groups except that the proportion of patients with a
body weight of 50 kg or more was greater in the 40 mg/day group. Otherwise, there were no significant differences between the two groups in the average
time to treatment failure (TTF), the rates at which the administration of a second-line
therapy was necessary, or the frequency and severity of adverse events. Overall, these results suggest that it is possible to calibrate the dosage of
afatinib to suit individual patient parameters such as low
body weight, and that such calibration can be advised based on the given patient's individual experience of the drug.