Real-World Analysis of Afatinib for EGFR-Mutated Lung Adenocarcinoma Under Universal Health Coverage: A Single Center Experience
| Author | Widya Angasreni | en |
| Author | Sita Andarini | en |
| Author | Mochammad Aris Arfiansyah | en |
| Author | Andintia Aisyah Santoso | en |
| Author | Jamal Zaini | en |
| Orcid | Widya Angasreni [0000-0003-0169-1109] | en |
| Orcid | Sita Andarini [0000-0003-0169-1109] | en |
| Orcid | Mochammad Aris Arfiansyah [0000-0002-3820-9489] | en |
| Orcid | Andintia Aisyah Santoso [0000-0002-1984-3388] | en |
| Orcid | Jamal Zaini [0000-0002-3573-6312] | en |
| Issued Date | 2025-12-31 | en |
| Abstract | Background: Afatinib, an epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), has now become standard targeted therapy for EGFR-mutated lung adenocarcinoma patients in Indonesia, and approved under universal health coverage scheme in Indonesia. Objectives: This study aimed to evaluate the outcomes and efficacy of afatinib therapy in lung adenocarcinoma patients with EGFR mutations at Persahabatan General Hospital, a tertiary referral respiratory hospital, under universal health coverage scheme. Methods: This retrospective cohort study was conducted based on medical records of EGFR-mutated lung adenocarcinoma patients who received afatinib at Thoracic Oncology Outpatient Clinic Persahabatan Hospital, between January 2018 and December 2021. All patients initially received afatinib at a dose of 40 mg dose, with some had dose reduction to 20 or 30 mg. Survival analysis was conducted using Kaplan-Meier and Log-Rank Test. Results: Among 86 participants, 78% were diagnosed with stage IVA disease at the initiation of afatinib therapy. Exon 19 deletion were observed in over 50% of patients, and pleural metastases were present in nearly 60%. The median progression-free survival (PFS) was 13 months (95% CI: 10.5 - 15.5), and the median overall survival (OS) was 17 months (95% CI: 14.9 -19.1). The one-year survival rate was 65.1%. Dose reduction occurred in 43% of participants, with no significant differences in survival outcomes. Median PFS was 15 months (95% CI: 12.4 - 17.6) with dose reduction and 12 months (95% CI: 8.1 - 15.9) without (P = 0.85). Median OS was 17 months (95% CI: 14.9 - 19.1) with dose reduction and 19 months (95% CI: 13.7 - 24.3) without (P = 0.59). Conclusions: Afatinib has comparable efficacy for EGFR-mutated lung adenocarcinoma patients and dose adjustment did not affect the survival rate, in patient under universal health coverage program in Indonesia. | en |
| DOI | https://doi.org/10.5812/ijcm-161143 | en |
| Keyword | Adenocarcinoma of Lung | en |
| Keyword | Afatinib | en |
| Keyword | Survival Analysis | en |
| Keyword | EGFR Mutation | en |
| Publisher | Brieflands | en |
| Title | Real-World Analysis of Afatinib for EGFR-Mutated Lung Adenocarcinoma Under Universal Health Coverage: A Single Center Experience | en |
| Type | Research Article | en |
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