KẾT QUẢ ĐIỀU TRỊ AFATINIB LIỀU LINH HOẠT Ở BỆNH NHÂN CAO TUỔI UTPKTBN CÓ ĐỘT BIẾN EGFR

Abstract

Objectives: Evaluate the results of Afatinib treatment in elderly patients with advanced stage NSCLC with EGFR mutations and effects of treatment. Patients and Methods: Retrospective descriptive study, longitudinal follow-up with a convenience sample of 230 patients with stage IV NSCLC ≥ 60 years old, with EGFR mutations, treated at 9 Departments and Cancer Centers across the country, from April 2018 - June 2022 with Afatinib. Results: The study was conducted on 230 patients. The average age is 68.4 years old, the proportion of men is 57.4%, the proportion of women is 42.6%, the majority of patients have ECOG PS overall status index 0 and 1, accounting for 94.3%; ECOG PS 2 and 3 accounted for 5.7%; 62.2% of patients did not smoke; Brain and liver metastases before treatment accounted for 26.5% and 7.8%. Common EGFR mutations (Del19, L858R) account for 71.7%, uncommon mutations account for 28.3%. Most patients were started with doses of 30 mg (59.6%) and 40 mg (38.7%), with the rate of keeping the same dose after 1 month of treatment accounting for 83.9%, the rate of dose reduction accounting for 83.9%. 9.1%. Treatment results: response rate 76.5%, disease control rate: 91.7%, no difference between treatment doses above or below 40 mg; survival time to treatment failure (mTTF) was 16.6 months. For patients with brain metastases, the response rate was 73.8%, mTTF 12.5 months. Side effects on the skin and mucous membranes are mainly paronychia (37%) and diarrhea (58.3%), mostly grade 1 and 2. Dosage reduction according to tolerance helps prolong mTTF while controlling better toxicity.