Randomized Phase II Study of Afatinib Plus Simvastatin Versus Afatinib Alone in Previously Treated Patients with Advanced Nonadenocarcinomatous Non-small Cell Lung Cancer.
- Author:
Youngjoo LEE
1
;
Ki Hyeong LEE
;
Geon Kook LEE
;
Soo Hyun LEE
;
Kun Young LIM
;
Jungnam JOO
;
Yun Jung GO
;
Jin Soo LEE
;
Ji Youn HAN
Author Information
- Publication Type:Original Article
- Keywords: EGFR tyrosine kinase inhibitor; EGFR mutation; Non-small-cell lung carcinoma; Squamous cell carcinoma; Statin
- MeSH: Arm; Carcinoma, Non-Small-Cell Lung*; Carcinoma, Squamous Cell; Diarrhea; Disease-Free Survival; Drug Therapy; Exanthema; Fluorescence; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immunohistochemistry; In Situ Hybridization; Receptor, Epidermal Growth Factor; Simvastatin*; Stomatitis
- From:Cancer Research and Treatment 2017;49(4):1001-1011
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This phase II study examined whether the addition of simvastatin to afatinib provides a clinical benefit compared with afatinib monotherapy in previously treated patients with nonadenocarcinomatous non-small cell lung cancer (NA-NSCLC). MATERIALS AND METHODS: Patients with advanced NA-NSCLC who progressed after one or two chemotherapy regimens were randomly assigned to a simvastatin (40 mg/day) plus afatinib (40 mg/day) (AS) arm or to an afatinib (A) arm. The primary endpoint was response rate (RR). RESULTS: Sixty-eight patients were enrolled (36 in the AS arm and 32 in the A arm). The RR was 5.7% (95% confidence interval [CI], 0.7 to 19.2) for AS and 9.4% (95% CI, 2.0 to 25.0) for A (p=0.440). In arms AS and A, the median progression-free survival (PFS) was 1.0 versus 3.6 months (p=0.240) and the overall survival was 10.0 months versus 7.0 months (p=0.930), respectively. Skin rash, stomatitis, and diarrhea were the most common adverse events in both arms. More grade 3 or 4 diarrhea was observed in arm A (18.8% vs. 5.6% in arm AS). In all patients, the median PFS for treatment including afatinib was not correlated with the status of epidermal growth factor receptor (EGFR) mutation (p=0.122), EGFR fluorescence in situ hybridization (p=0.944), or EGFR immunohistochemistry (p=0.976). However, skin rash severity was significantly related to the risk of progression for afatinib (hazard ratio for skin rash grade ≥ 2 vs. grade < 2, 0.44; 95% CI, 0.25 to 0.78; p=0.005). CONCLUSION: There were no significant differences in the efficacy between AS and A arms in patients with NA-NSCLC.
