Skip to content

Real-World Effectiveness of Afatinib (Gilotrif) Following Immunotherapy in the Treatment of Metastatic, Squamous Cell Carcinoma of the Lung: A Multi-Site Retrospective Chart Review Study in the U.S.

Assessment of Real-World Outcomes Associated With Afatinib (Gilotrif) Use in Patients With Solid Tumors Harboring NRG1 Gene Fusions

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT04750824
Enrollment
110
Registered
2021-02-11
Start date
2020-10-15
Completion date
2021-12-20
Last updated
2024-09-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Non-squamous, Non-Small Cell Lung Cancer

Brief summary

Characteristics of patients with Neuregulin-1 (NRG1) gene fusion-positive solid tumors treated with afatinib, and characteristics of those treated with another systemic therapy.

Interventions

DRUGAfatinib

Afatinib

DRUGother systemic therapy

other systemic therapy

Sponsors

Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
RETROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Adults, 18 years of age or older, at the time of diagnosis with any solid tumor. * Confirmed NRG1 gene fusion in any solid tumor. * Initiated afatinib or other systemic therapy (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01/01/2017 through 03/31/2020. * Followed up for ≥3 months after initiation of afatinib or other systemic therapy (unless deceased prior to 3 months of follow-up).

Exclusion criteria

\- Treatment with any Tyrosine kinase inhibitor (TKI)/ErbB-directed therapy other than afatinib

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR): Based on Charted/Physician-reported Disease ResponseFrom the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response (response based on the scan where the patient showed the best response to treatment (not progression)). Charted/physician-reported (physician-provided information as recorded in patient's chart) ORR is reported.
Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 CriteriaFrom the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.ORR based on lesion measurements and RECIST v1.1 criteria is reported. ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): CR: Disappearance of all target lesions or disappearance of all non-target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Duration of Objective Response (DOR)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.DOR was defined as the time from initial response (for any patient with a complete or partial response initially) until the earliest of either disease progression or death. Duration of response is reported for those patients who had a complete or partial response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.
Duration of Clinical Benefit (DOCB)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.DOCB was defined as the time from initial response (for any patient with a complete, partial, or stable disease response initially) until the earliest of either disease progression or death. DOCB reported for those patients who had a complete, partial or response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.
Progression Free Survival (PFS)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.PFS was defined as time from initiation of a line of therapy until disease progression or death; patients on therapy at the time of data cut-off were censored on the last date of treatment. Patients who discontinued a line of therapy for a reason other than disease progression but who subsequently die prior to the receipt of any other therapy were considered an event on the date of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): Progressive disease (PD): at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study), or unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 millimeter (mm).
Time on Treatment (TOT)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.TOT was defined as time from initiation of a line of therapy until discontinuation for any reason. Patients on therapy at the time of data cut-off were censored on the last date of treatment.
Time to Progression (TTP)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.TTP was defined as time from initiation of a line of therapy until discontinuation due to disease progression. Patients on therapy or those who discontinued due to a reason other than disease progression were censored on the last date of treatment.
Overall Survival (OS)From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.OS was defined as time from initiation of any therapy in the metastatic setting until death. Patients alive at the time of data cut-off were censored on the last date the patient was seen by the provider/clinic.
Number of Patients Who Experienced Any ADRs During Index Treatment LineFrom the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.Number of patients who experienced any averse drug reactions (ADRs) during index treatment line is reported. An ADR was defined as a response to a medicinal product which is noxious and unintended. Response in this context means that a causal relationship between a medicinal product and an adverse event (AE) is at least a reasonable possibility.

Countries

United States

Participant flow

Recruitment details

This was a non-interventional, retrospective, United States (US), multi-site, cohort study based on existing data from medical records of patients with Neuregulin-1 (NRG1) gene fusion-positive solid tumors treated with afatinib or other systemic therapy.

Pre-assignment details

Only subjects that met all inclusion and none of the exclusion criteria were included.

Participants by arm

ArmCount
All Afatinib Patients
Patients with a confirmed Neuregulin-1 (NRG1) gene fusion in any solid tumor, who initiated treatment with afatinib (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01-January-2017 through 31-March-2020 and followed up for ≥3 months after initiation of afatinib (unless deceased prior to 3 months of follow-up).
72
All Non-afatinib (Other Systemic Therapies)
Patients with a confirmed Neuregulin-1 (NRG1) gene fusion in any solid tumor, who initiated treatment with other systemic therapies than afatinib (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01-January-2017 through 31-March-2020 and followed up for ≥3 months after initiation of other systemic therapies than afatinib (unless deceased prior to 3 months of follow-up).
38
Total110

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath13
Overall StudyDisease progression (confirmed with scan)5711
Overall StudyScheduled duration of therapy complete19
Overall StudyToxicity/intolerability31

Baseline characteristics

CharacteristicAll Non-afatinib (Other Systemic Therapies)All Afatinib PatientsTotal
Age, Continuous66 Years62 Years62.5 Years
Comorbidities
Cardiovascular disease
14 Participants0 Participants14 Participants
Comorbidities
Chronic pulmonary disease
12 Participants16 Participants28 Participants
Comorbidities
Depression
0 Participants17 Participants17 Participants
Comorbidities
Diabetes with chronic complications
12 Participants0 Participants12 Participants
Comorbidities
Hypertension
21 Participants29 Participants50 Participants
Comorbidities
None of the above
10 Participants15 Participants25 Participants
Eastern Cooperative Oncology Group Performance Status (ECOG-PS)
0,1
26 Participants22 Participants48 Participants
Eastern Cooperative Oncology Group Performance Status (ECOG-PS)
2+
12 Participants50 Participants62 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants10 Participants15 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
33 Participants62 Participants95 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Geographic Region
Midwest
4 Participants5 Participants9 Participants
Geographic Region
Northeast
10 Participants26 Participants36 Participants
Geographic Region
South
24 Participants15 Participants39 Participants
Geographic Region
West
0 Participants26 Participants26 Participants
Line of therapy in which index therapy was received
First line therapy (1L)
36 Participants16 Participants52 Participants
Line of therapy in which index therapy was received
Second line therapy (2L)
2 Participants51 Participants53 Participants
Line of therapy in which index therapy was received
≥ third line therapy (3L+)
0 Participants5 Participants5 Participants
NRG1 testing characteristics: NRG1 testing location
Caris Life Sciences
0 Participants15 Participants15 Participants
NRG1 testing characteristics: NRG1 testing location
Foundation One
27 Participants29 Participants56 Participants
NRG1 testing characteristics: NRG1 testing location
Other
1 Participants3 Participants4 Participants
NRG1 testing characteristics: NRG1 testing location
Specialty gene testing lab
7 Participants11 Participants18 Participants
NRG1 testing characteristics: NRG1 testing location
Tempus
0 Participants3 Participants3 Participants
NRG1 testing characteristics: NRG1 testing location
Unknown
3 Participants11 Participants14 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
0 Participants6 Participants6 Participants
Race (NIH/OMB)
Black or African American
16 Participants16 Participants32 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
22 Participants48 Participants70 Participants
Sex: Female, Male
Female
18 Participants30 Participants48 Participants
Sex: Female, Male
Male
20 Participants42 Participants62 Participants
Smoking status at initiation of index therapy
Current smoker
2 Participants2 Participants4 Participants
Smoking status at initiation of index therapy
Never smoked
14 Participants32 Participants46 Participants
Smoking status at initiation of index therapy
Past history of smoking
22 Participants38 Participants60 Participants
Tumor stage at initiation of index therapy
Stage I
0 Participants0 Participants0 Participants
Tumor stage at initiation of index therapy
Stage II
3 Participants1 Participants4 Participants
Tumor stage at initiation of index therapy
Stage III
1 Participants6 Participants7 Participants
Tumor stage at initiation of index therapy
Stage IV
34 Participants65 Participants99 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 723 / 38
other
Total, other adverse events
2 / 723 / 38
serious
Total, serious adverse events
0 / 724 / 38

Outcome results

Primary

Duration of Clinical Benefit (DOCB)

DOCB was defined as the time from initial response (for any patient with a complete, partial, or stable disease response initially) until the earliest of either disease progression or death. DOCB reported for those patients who had a complete, partial or response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020 and had a complete, partial, or stable disease response according to charted/physician-reported disease response.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsDuration of Clinical Benefit (DOCB)5.85 months
All Non-afatinib (Other Systemic Therapies)Duration of Clinical Benefit (DOCB)13.38 months
First Line Afatinib PatientsDuration of Clinical Benefit (DOCB)NA months
First Line Non-afatinib PatientsDuration of Clinical Benefit (DOCB)13.38 months
Primary

Duration of Objective Response (DOR)

DOR was defined as the time from initial response (for any patient with a complete or partial response initially) until the earliest of either disease progression or death. Duration of response is reported for those patients who had a complete or partial response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020 and had a complete or partial response according to charted/physician-reported disease response.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsDuration of Objective Response (DOR)5.851 months
All Non-afatinib (Other Systemic Therapies)Duration of Objective Response (DOR)13.38 months
First Line Afatinib PatientsDuration of Objective Response (DOR)NA months
First Line Non-afatinib PatientsDuration of Objective Response (DOR)13.38 months
Primary

Number of Patients Who Experienced Any ADRs During Index Treatment Line

Number of patients who experienced any averse drug reactions (ADRs) during index treatment line is reported. An ADR was defined as a response to a medicinal product which is noxious and unintended. Response in this context means that a causal relationship between a medicinal product and an adverse event (AE) is at least a reasonable possibility.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
All Afatinib PatientsNumber of Patients Who Experienced Any ADRs During Index Treatment Line7 Participants
All Non-afatinib (Other Systemic Therapies)Number of Patients Who Experienced Any ADRs During Index Treatment Line8 Participants
First Line Afatinib PatientsNumber of Patients Who Experienced Any ADRs During Index Treatment Line2 Participants
First Line Non-afatinib PatientsNumber of Patients Who Experienced Any ADRs During Index Treatment Line8 Participants
Primary

Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response

ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response (response based on the scan where the patient showed the best response to treatment (not progression)). Charted/physician-reported (physician-provided information as recorded in patient's chart) ORR is reported.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (NUMBER)
All Afatinib PatientsObjective Response Rate (ORR): Based on Charted/Physician-reported Disease Response37.5 percentage of patients
All Non-afatinib (Other Systemic Therapies)Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response76.3 percentage of patients
First Line Afatinib PatientsObjective Response Rate (ORR): Based on Charted/Physician-reported Disease Response43.8 percentage of patients
First Line Non-afatinib PatientsObjective Response Rate (ORR): Based on Charted/Physician-reported Disease Response77.8 percentage of patients
Primary

Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria

ORR based on lesion measurements and RECIST v1.1 criteria is reported. ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): CR: Disappearance of all target lesions or disappearance of all non-target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (NUMBER)
All Afatinib PatientsObjective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria34.7 percentage of patients
All Non-afatinib (Other Systemic Therapies)Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria71.1 percentage of patients
First Line Afatinib PatientsObjective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria43.8 percentage of patients
First Line Non-afatinib PatientsObjective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria72.2 percentage of patients
Primary

Overall Survival (OS)

OS was defined as time from initiation of any therapy in the metastatic setting until death. Patients alive at the time of data cut-off were censored on the last date the patient was seen by the provider/clinic.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsOverall Survival (OS)7.166 months
All Non-afatinib (Other Systemic Therapies)Overall Survival (OS)22.551 months
First Line Afatinib PatientsOverall Survival (OS)9.928 months
First Line Non-afatinib PatientsOverall Survival (OS)22.55 months
Primary

Progression Free Survival (PFS)

PFS was defined as time from initiation of a line of therapy until disease progression or death; patients on therapy at the time of data cut-off were censored on the last date of treatment. Patients who discontinued a line of therapy for a reason other than disease progression but who subsequently die prior to the receipt of any other therapy were considered an event on the date of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): Progressive disease (PD): at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study), or unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 millimeter (mm).

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsProgression Free Survival (PFS)5.490 months
All Non-afatinib (Other Systemic Therapies)Progression Free Survival (PFS)12.886 months
First Line Afatinib PatientsProgression Free Survival (PFS)6.345 months
First Line Non-afatinib PatientsProgression Free Survival (PFS)12.89 months
Primary

Time on Treatment (TOT)

TOT was defined as time from initiation of a line of therapy until discontinuation for any reason. Patients on therapy at the time of data cut-off were censored on the last date of treatment.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsTime on Treatment (TOT)5.42 months
All Non-afatinib (Other Systemic Therapies)Time on Treatment (TOT)5.08 months
First Line Afatinib PatientsTime on Treatment (TOT)6.34 months
First Line Non-afatinib PatientsTime on Treatment (TOT)5.08 months
Primary

Time to Progression (TTP)

TTP was defined as time from initiation of a line of therapy until discontinuation due to disease progression. Patients on therapy or those who discontinued due to a reason other than disease progression were censored on the last date of treatment.

Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.

Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.

ArmMeasureValue (MEDIAN)
All Afatinib PatientsTime to Progression (TTP)5.49 months
All Non-afatinib (Other Systemic Therapies)Time to Progression (TTP)12.89 months
First Line Afatinib PatientsTime to Progression (TTP)6.44 months
First Line Non-afatinib PatientsTime to Progression (TTP)12.89 months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026