EU approves Giotrif (afatinib) for advanced squamous cell carcinoma (SqCC) of the lung- Boehringer

Boehringer announced that the European Commission (EC) has granted marketing authorisation for Giotrif (afatinib) for the treatment of patients with advanced squamous cell carcinoma (SqCC) of the lung whose disease has progressed on or after treatment with platinum-based chemotherapy. Afatinib is already approved for the treatment of patients with EGFR mutation-positive non-small cell lung cancer (NSCLC).

The marketing authorisation in Europe is valid for 28 countries within the EU. The EU regulatory submission was based on results of the head-to-head LUX-Lung 8 trial in patients with SqCC of the lung whose tumours progressed on or after first-line chemotherapy. Afatinib, compared to erlotinib, demonstrated significant delay in progression of lung cancer (PFS, progression-free survival, primary endpoint), reducing the risk of cancer progression by 19%, plus significant improvement in overall survival (OS, key secondary endpoint), reducing the risk of death by 19%. It also significantly improved disease control rate (51% vs 40%) and demonstrated an improvement in quality of life and control of cancer symptoms.

The rate of severe adverse events was similar between the two treatment arms with differences observed in the incidence of certain side effects: a higher incidence of severe diarrhoea and stomatitis (mouth sores) was observed with afatinib compared to erlotinib (grade 3 diarrhoea: 10% vs 2%; grade 3 stomatitis: 4% vs 0%), while a higher incidence of severe rash/acne was reported with erlotinib compared to afatinib (grade 3 rash/acne: 10% vs 6%).

Comment: LUX-Lung 8 (NCT01523587) is part of the afatinib LUX-Lung programme – the largest collection of clinical trials of any EGFR tyrosine kinase inhibitor (TKI), with over 3,760 patients across eight studies conducted across the world. The comprehensive LUX-Lung programme includes two pivotal studies in the first-line setting for EGFR mutation-positive patients, LUX-Lung 3 and 6 which compared afatinib to chemotherapy regimens. In addition, the programme included two head-to-head studies (LUX-Lung 7 and 8) of afatinib versus first-generation EGFR TKIs. The LUX-Lung programme has involved over 680 sites in 40 countries, reflecting the strong partnership between Boehringer Ingelheim and the lung cancer specialist community.