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Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use
BACKGROUND: Afatinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor with significant serum protein binding. Total protein level was found to be associated with plasma afatinib level. The trough serum concentration was shown to be associated with development of adverse effect...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264096/ https://www.ncbi.nlm.nih.gov/pubmed/35813726 http://dx.doi.org/10.21037/jtd-21-1649 |
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author | Kwok, Wang Chun Ho, James Chung Man Tam, Terence Chi Chun Ip, Mary Sau Man Lam, David Chi Leung |
author_facet | Kwok, Wang Chun Ho, James Chung Man Tam, Terence Chi Chun Ip, Mary Sau Man Lam, David Chi Leung |
author_sort | Kwok, Wang Chun |
collection | PubMed |
description | BACKGROUND: Afatinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor with significant serum protein binding. Total protein level was found to be associated with plasma afatinib level. The trough serum concentration was shown to be associated with development of adverse effects. This study aims to explore the association between serum protein levels and clinical responses and adverse effects in advanced stage non-small cell lung cancer (NSCLC) treated with afatinib. METHODS: This was a retrospective cohort study of Chinese patients with metastatic NSCLC harboring EGFR mutations who received first or second line afatinib treatment. The association of serum protein and album levels, as well as their ratio, and the development of adverse effects was investigated. RESULTS: Among 217 patients included, 91 were on afatinib as first line treatment and 126 as second line treatment. Higher serum protein levels, albumin levels and albumin to globulin ratio, were found to be associated with clinical response to afatinib among patients on first or second line setting. Among patients on first line afatinib with Eastern Cooperative Oncology Group Performance State (ECOG PS) at 1 or above, those with lower serum protein levels at baseline had higher risks of developing grade 2 or above gastrointestinal adverse effects. Among patients on second line afatinib and with ECOG PS at 1 or above, patients with lower serum protein levels at baseline had higher risks of developing grade 3 or above cutaneous adverse effects. Lower serum albumin to globulin ratio at baseline was associated with increased risks of grade 3 or above gastrointestinal adverse effects among patients with ECOG PS at 1 or above and no prior systemic chemotherapy. CONCLUSIONS: Serum protein, albumin level and serum albumin to globulin ratio may predict the response to afatinib and occurrence of adverse effects with afatinib treatment. |
format | Online Article Text |
id | pubmed-9264096 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-92640962022-07-09 Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use Kwok, Wang Chun Ho, James Chung Man Tam, Terence Chi Chun Ip, Mary Sau Man Lam, David Chi Leung J Thorac Dis Original Article BACKGROUND: Afatinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor with significant serum protein binding. Total protein level was found to be associated with plasma afatinib level. The trough serum concentration was shown to be associated with development of adverse effects. This study aims to explore the association between serum protein levels and clinical responses and adverse effects in advanced stage non-small cell lung cancer (NSCLC) treated with afatinib. METHODS: This was a retrospective cohort study of Chinese patients with metastatic NSCLC harboring EGFR mutations who received first or second line afatinib treatment. The association of serum protein and album levels, as well as their ratio, and the development of adverse effects was investigated. RESULTS: Among 217 patients included, 91 were on afatinib as first line treatment and 126 as second line treatment. Higher serum protein levels, albumin levels and albumin to globulin ratio, were found to be associated with clinical response to afatinib among patients on first or second line setting. Among patients on first line afatinib with Eastern Cooperative Oncology Group Performance State (ECOG PS) at 1 or above, those with lower serum protein levels at baseline had higher risks of developing grade 2 or above gastrointestinal adverse effects. Among patients on second line afatinib and with ECOG PS at 1 or above, patients with lower serum protein levels at baseline had higher risks of developing grade 3 or above cutaneous adverse effects. Lower serum albumin to globulin ratio at baseline was associated with increased risks of grade 3 or above gastrointestinal adverse effects among patients with ECOG PS at 1 or above and no prior systemic chemotherapy. CONCLUSIONS: Serum protein, albumin level and serum albumin to globulin ratio may predict the response to afatinib and occurrence of adverse effects with afatinib treatment. AME Publishing Company 2022-06 /pmc/articles/PMC9264096/ /pubmed/35813726 http://dx.doi.org/10.21037/jtd-21-1649 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Kwok, Wang Chun Ho, James Chung Man Tam, Terence Chi Chun Ip, Mary Sau Man Lam, David Chi Leung Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title | Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title_full | Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title_fullStr | Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title_full_unstemmed | Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title_short | Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
title_sort | serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264096/ https://www.ncbi.nlm.nih.gov/pubmed/35813726 http://dx.doi.org/10.21037/jtd-21-1649 |
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