KẾT QUẢ ĐIỀU TRỊ BƯỚC MỘT AFATINIB Ở BỆNH NHÂN UNG THƯ PHỔI KHÔNG TẾ BÀO NHỎ GIAI ĐOẠN IIIC - IV TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: To evaluate the efficacy and safety of first-line afatinib for patients with stage IIIC-IV non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations at Hanoi Medical University Hospital. Patients and Methods: A retrospective, descriptive study was conducted on 45 patients with EGFR-mutated stage IIIC-IV NSCLC treated with first-line afatinib from April 2020 to April 2025. Results: The median age of patients was 64 years (range: 35-83). Females comprised 63.41% (26/41) of the cohort, and 58.54% (24/41) were never-smokers. 87.8% of patients had an ECOG performance status of 0-1. Exon 19 deletion mutations accounted for 56.1% (23/41), L858R for 31.7% (13/41), and uncommon mutations for 12.2% (5/41). Brain metastases were present in 31.71% (13/41) of patients. The objective response rate (ORR) was 78.1%, and the disease control rate (DCR) was 92.7%. The median progression-free survival (PFS) was 15.1 months. In the common mutation group, the median PFS was 16.6 months. The intracranial response rate in the brain metastasis group was 61.1% (8/13), with 4/13 patients (30.7%) receiving brain radiotherapy. 10/41 patients required a dose reduction due to adverse events. The most common adverse events were diarrhea (86.7%) and rash (82.2%), which were predominantly grade 1-2 and manageable. Conclusion: Afatinib is an effective first-line treatment for Vietnamese patients with EGFR-mutated stage IIIC-IV NSCLC, providing high response and disease control rates, improved progression-free survival, and a tolerable safety profile.