New developments in the treatment of advanced squamous cell lung cancer: focus on afatinib

Figures & data

Table 1 Clinical activity of EGFR-targeted agents in patients with SqCC of the lung

Treatment setting	Trial/analysis	Patient population	Treatment arms	Efficacy end points	Key outcomes	Reference(s)
First line	SQUIRE	SqCC; no prior systemic Tx	Necitumumab plus gemcitabine/cisplatin vs chemotherapy	OS (primary)	Significant OS improvement with combination; acceptable safety profile in SqCC	^Citation22
	Subanalysis of four randomized Phase II/III trials		Cetuximab plus platinum-based chemotherapy vs chemotherapy	OS, PFS	Significant OS, PFS, and response (odds ratio) improvements in overall NSCLC population	^Citation26^–^Citation28, ^Citation30
Second line	Subanalysis of BR.21	NSCLC; progressed after first/second-line chemotherapy	Erlotinib vs placebo	OS (primary), PFS	Favorable OS/PFS outcomes in SqCC and adenocarcinoma; no differential effect on OS/PFS between histology groups; slightly higher rates of grade 3–5 AEs than in adenocarcinoma group	^Citation37
	Subanalysis of TAILOR	NSCLC; wild-type EGFR; prior platinum-based chemotherapy	Erlotinib vs docetaxel	OS (primary), PFS	Better OS and PFS outcomes with docetaxel vs erlotinib, including in patients with SqCC	^Citation40
	LUX-Lung 8	SqCC; progression after ≥4 cycles of platinum-based chemotherapy	Afatinib vs erlotinib	PFS (primary), OS	Significant PFS and OS improvements with afatinib vs erlotinib; acceptable safety profile in SqCC	^Citation62
Maintenance	SATURN	NSCLC; previously untreated; 4 cycles of first-line platinum-doublet chemotherapy without progression (run-in period)	Erlotinib vs placebo	PFS (primary), OS	Favorable PFS in SqCC and adenocarcinoma; no differential effect on PFS between histology groups; similar rates of grade 3–5 AEs in SqCC and adenocarcinoma groups	^Citation37

Abbreviations: AEs, adverse events; EGFR, epidermal growth factor receptor; NSCLC, non-small-cell lung cancer; OS, overall survival; PFS, progression-free survival; SqCC, squamous cell carcinoma; Tx, treatment.

Figure 1 Afatinib mechanism of action.

Notes: From Hirsh,⁴⁵ with permission. Boehringer Ingelheim Pharma GmbH & Co. KG.

Figure 2 OS and PFS in the overall LUX-Lung 8 population (n=795).

Notes: (A) OS; (B) PFS. Reprinted from Lancet Oncol, vol 16(8). Soria JC, Felip E, Cobo M, et al. Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8): an open-label randomised controlled phase 3 trial. Pages: 897–907. Copyright 2015, with permission from Elsevier.⁶¹
Abbreviations: CI, confidence interval; HR, hazard ratio; OS, overall survival; PFS, progression-free survival.

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