Meet Sarah,* a EGFR M+ mNSCLC patient with a del19 mutation

  • 58 years old
  • Diagnosed with stage IV adenocarcinoma
  • No presence of brain metastasis at diagnosis
  • Started GILOTRIF as a first-line treatment
For patients like Sarah with a del19 mutation, consider GILOTRIF first-line

*Not an actual patient
EGFR M+=epidermal growth factor receptor mutation positive;
mNSCLC=metastatic non-small cell lung cancer

Nearly 3 years overall survival (OS) in patients with del19 mutations1,4‡§​

Median OS in LUX-Lung 3: del19 mutations population1,4​

The majority of patients with a del19 mutation, up to 70%, may go on to develop a T790M mutation

After treatment with first- or second‑generation EGFR TKIs.6

 

Sarah’s follow-up at 13 months

  • CT scan reveals evidence of progressive disease with a T790M mutation
  • No presence of metastasis to the brain

In patients without baseline brain metastases, the incidence of CNS progression was 6.3% in a pooled analysis of LUX-Lung 3 and 67‖

Limitations of the pooled post hoc analysis data: Data censored in 59 of 351 patients (17%). LUX Lung 3 and 6 were not powered nor error controlled to assess CNS response. Treatment effects observed in this analysis cannot be regarded as statistically significant. The analysis described here was exploratory.

Know your patient’s options. Consider GILOTRIF first-line.

See Real-World Evidence in observational study – GioTag.

Resources for You

del19 Patient Profile
Uncommon EGFR Mutation Profile
Squamous NSCLC Profile
Patient Appointment Checklist
GILOTRIF Clinical Information
Patient Care Guide
GILOTRIF Prescription and Enrollment Form

Resources for Your Patients

GILOTRIF Patient Starter Guide
14-Day Patient Tear Sheets

References: 1. GILOTRIF [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. 2. Hochmair MJ, Morabito A, Hao D, et al. Sequential treatment with afatinib and osimertinib in patients with EGFR mutation-positive non-small-cell lung cancer: an observational study [published online October 19, 2018]. Future Oncol. doi:10.2217/fon-2018-0711 3. Halmos B, Tan EH, Soo Ra, et al. Impact of afatinib dose modification on safety and effectiveness in patients with EGFR mutation-positive advanced NSCLC: results from a global real-world study (RealGido). Lung Cancer. 2019;127:103-11. 4. Yang JCH, Wu YL, Schuler M, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol. 2015;16(2):141-151. 5. Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31(27):3327-3334. 6. Ke EE, Zhou Q, Zhang QY, et al. A higher proportion of the EGFR T790M mutation may contribute to the better survival of patients with exon 19 deletions compared with those with L858R. J Thorac Oncol. 2017;12(9):1368-1375. 7. Data on file. Boehringer Ingelheim. CTR. 8. Lee CK, Wu YL, Ding PN, et al. Impact of specific epidermal growth factor receptor (EGFR) mutations and clinical characteristics on outcomes after treatment with EGFR tyrosine kinase inhibitors versus chemotherapy in EGFR-mutant lung cancer: a meta-analysis. J Clin Oncol. 2015;33(17):1958-1965. 9. Yang JC, Sequist LV, Geater SL, et al. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX- Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol. 2015;16(7):830-838. 10. Yang JCH, Wu JYS, Hsia TC, et al. Afatinib for patients with lung adenocarcinoma and epidermal growth factor receptor mutations (LUX-Lung 2): a phase 2 trial. Lancet Oncol. 2012;13:539-548. 11. Wu YL, Zhou C, Hu CP, et al. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15(2):213-222. 12. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: non-small cell lung cancer, version 5. 2018. 13. 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. Lancet Oncol. 2015;16(8):897 907. 14. Yang JCH, Sequist LV, Zhou C, et al. Effect of dose adjustment on the safety and efficacy of afatinib for EGFR mutation-positive lung adenocarcinoma: post hoc analyses of the randomized LUX-Lung 3 and 6 trials. Ann Oncol. 2016;27(11):2103-2110.  15. U.S. Food & Drug Administration (FDA). FDA broadens afatinib indication to previously untreated, metastatic NSCLC with other non-resistant EGFR mutations (press release). https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm592558.htm. Accessed 3.13.2019.

Indications and usage

  • GILOTRIF (afatinib) tablets is indicated for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have non-resistant epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test.

    Limitation of Use: Safety and efficacy of GILOTRIF have not been established in patients whose tumors have resistant EGFR mutations.

  • GILOTRIF is indicated for the treatment of patients with metastatic squamous NSCLC progressing after platinum-based chemotherapy.