Advanced Squamous Cell Carcinoma of the Lung: Current Treatment Approaches and the Role of Afatinib.
| Title: | Advanced Squamous Cell Carcinoma of the Lung: Current Treatment Approaches and the Role of Afatinib. |
|---|---|
| Authors: | Santos, Edgardo S (AUTHOR), Hart, Lowell (AUTHOR) |
| Source: | OncoTargets & Therapy. Sep2020, Vol. 13, p9305-9321. 17p. |
| Subject Terms: | *PEMBROLIZUMAB, *SQUAMOUS cell carcinoma, *IMMUNE checkpoint inhibitors, *PEMETREXED, *COMBINATION drug therapy, *LUNGS, *PROGRESSION-free survival |
| Abstract: | Options for the treatment of squamous cell lung carcinoma expanded in recent years with the introduction of the immune checkpoint inhibitors into routine clinical practice in both the first- and second-line settings but are still limited. As a result, pembrolizumab, given either alone or in combination with platinum-based chemotherapy, is now a standard first-line treatment for squamous cell lung cancer. However, few options exist once patients have progressed on immune checkpoint inhibitors and chemotherapy. In this setting, the irreversible ErbB family blocker, afatinib, has a potential role as second or subsequent therapy for some patients. The Phase III LUX-Lung 8 study demonstrated that afatinib significantly prolonged progression-free and overall survival compared with erlotinib in patients with squamous cell lung carcinoma. Notably, retrospective, ad-hoc biomarker analyses of a subset of patients from LUX-Lung 8 suggested that patients with ErbB family mutations derived particular benefit from afatinib, especially those with ErbB2 (HER2) mutations. Afatinib has a manageable and predictable safety profile, and adverse events can be managed with the use of a tolerability-guided dose modification protocol. Until more data are available, afatinib could be considered as a potential second-line treatment option for patients who have progressed on combined pembrolizumab and platinum-based chemotherapy and are ineligible for more established second-line options, or as a third-line option in patients who have received first-line immunotherapy, and second-line chemotherapy or chemotherapy and antiangiogenesis therapy. However, further data are required to support the use of afatinib following immunotherapy. Given that treatment options are limited in both of these settings, investigating an agent with an entirely new mechanism of action is warranted. If available, molecular analysis to identify ErbB family mutations or the use of proteomic profiling could help to further isolate patients who are likely to derive the most benefit from afatinib. [ABSTRACT FROM AUTHOR] |
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| Items | – Name: Title Label: Title Group: Ti Data: Advanced Squamous Cell Carcinoma of the Lung: Current Treatment Approaches and the Role of Afatinib. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Santos%2C+Edgardo+S%22">Santos, Edgardo S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hart%2C+Lowell%22">Hart, Lowell</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22OncoTargets+%26+Therapy%22">OncoTargets & Therapy</searchLink>. Sep2020, Vol. 13, p9305-9321. 17p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22PEMBROLIZUMAB%22">PEMBROLIZUMAB</searchLink><br />*<searchLink fieldCode="DE" term="%22SQUAMOUS+cell+carcinoma%22">SQUAMOUS cell carcinoma</searchLink><br />*<searchLink fieldCode="DE" term="%22IMMUNE+checkpoint+inhibitors%22">IMMUNE checkpoint inhibitors</searchLink><br />*<searchLink fieldCode="DE" term="%22PEMETREXED%22">PEMETREXED</searchLink><br />*<searchLink fieldCode="DE" term="%22COMBINATION+drug+therapy%22">COMBINATION drug therapy</searchLink><br />*<searchLink fieldCode="DE" term="%22LUNGS%22">LUNGS</searchLink><br />*<searchLink fieldCode="DE" term="%22PROGRESSION-free+survival%22">PROGRESSION-free survival</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Options for the treatment of squamous cell lung carcinoma expanded in recent years with the introduction of the immune checkpoint inhibitors into routine clinical practice in both the first- and second-line settings but are still limited. As a result, pembrolizumab, given either alone or in combination with platinum-based chemotherapy, is now a standard first-line treatment for squamous cell lung cancer. However, few options exist once patients have progressed on immune checkpoint inhibitors and chemotherapy. In this setting, the irreversible ErbB family blocker, afatinib, has a potential role as second or subsequent therapy for some patients. The Phase III LUX-Lung 8 study demonstrated that afatinib significantly prolonged progression-free and overall survival compared with erlotinib in patients with squamous cell lung carcinoma. Notably, retrospective, ad-hoc biomarker analyses of a subset of patients from LUX-Lung 8 suggested that patients with ErbB family mutations derived particular benefit from afatinib, especially those with ErbB2 (HER2) mutations. Afatinib has a manageable and predictable safety profile, and adverse events can be managed with the use of a tolerability-guided dose modification protocol. Until more data are available, afatinib could be considered as a potential second-line treatment option for patients who have progressed on combined pembrolizumab and platinum-based chemotherapy and are ineligible for more established second-line options, or as a third-line option in patients who have received first-line immunotherapy, and second-line chemotherapy or chemotherapy and antiangiogenesis therapy. However, further data are required to support the use of afatinib following immunotherapy. Given that treatment options are limited in both of these settings, investigating an agent with an entirely new mechanism of action is warranted. If available, molecular analysis to identify ErbB family mutations or the use of proteomic profiling could help to further isolate patients who are likely to derive the most benefit from afatinib. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of OncoTargets & Therapy is the property of Dove Medical Press Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.2147/OTT.S250446 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 17 StartPage: 9305 Subjects: – SubjectFull: PEMBROLIZUMAB Type: general – SubjectFull: SQUAMOUS cell carcinoma Type: general – SubjectFull: IMMUNE checkpoint inhibitors Type: general – SubjectFull: PEMETREXED Type: general – SubjectFull: COMBINATION drug therapy Type: general – SubjectFull: LUNGS Type: general – SubjectFull: PROGRESSION-free survival Type: general Titles: – TitleFull: Advanced Squamous Cell Carcinoma of the Lung: Current Treatment Approaches and the Role of Afatinib. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Santos, Edgardo S – PersonEntity: Name: NameFull: Hart, Lowell IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2020 Type: published Y: 2020 Identifiers: – Type: issn-print Value: 11786930 Numbering: – Type: volume Value: 13 Titles: – TitleFull: OncoTargets & Therapy Type: main |
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