Response to Afatinib, an irreversible EGFR-TKI in a patient with advanced squamous carcinoma of lung
Ruchir Tandon
Jaypee Hospital, India
: J Nurs Patient Care
Abstract
Advanced squamous cell carcinoma of the lung, accounts for 20-30% of cases of non-small cell lung cancer. After the failure of first-line platinum-based doublet chemotherapy, there are very few treatment options available to these patients. There is a dearth of approved drugs targeting driver mutations which are responsible for carcinogenesis in squamous carcinoma of lung, despite specific molecular targets being identified. The rationale for targeting EGFR in patients with squamous cell carcinoma of the lung is supported by trials showing an improvement in overall survival when the anti EGFR monoclonal antibodies were added to first-line platinum doublet chemotherapy compared with doublet chemotherapy only. In addition to EGFR, other members of the Erb B family have been implicated in the pathogenesis of squamous cell carcinoma. Hence it was hypothesized that Afatinib, an irreversible Erb B-family inhibitor which selectively blocks signaling from all homodimers and heterodimers will act against squamous carcinoma of lung. Many molecular targets are similar in both adeno and squamous carcinomas. Therefore, it made logical sense to try targeted therapies which have shown overall survival benefits in adenocarcinoma of lung, especially after all the established treatment modalities are exhausted. In this study the progression free survival was more than 6 months with Afatinib used in fourth line in squamous cell carcinoma of lung which is more than the progression free survival seen in LUX-Lung 8 trial, where patients received Afatinib in second line. To add on the patient had stable disease at the time of end of study.
Biography
Ruchir Tandon has obtained his MBBS degree from R G Kar Medical College, Calcutta and then pursued his Diploma in National Board in Oncology from Dharamshila Cancer Hospital and Research Center, Delhi. He has served in many hospitals of Delhi-NCR and currently he is a Consultant in Department of Medical Oncology at Jaypee Hospital, Noida and Bulandshahr. He has Membership of ASCO and ESMO. Has published papers in reputed journals and is actively involved in oncology research. His interest is in targeted therapy and immunotherapy.
E-mail: dr.ruchirtandon@gmail.com
