FDA：勃林格殷格翰用于NSCLC药物afatinib获FDA批准

勃林格殷格翰（Boehringer Ingelheim）今天宣布，FDA已批准afatinib片以商品名Gilotrif上市，作为一种口服的、新的一线治疗药物，用于经由FDA批准的试剂盒证实肿瘤表皮生长因子受体（EGFR）19号外显子缺失或21号外显子突变（L858R）的转移性非小细胞肺癌（NSCLC）患者的治疗。

此前，afatinib获FDA授予孤儿药地位，并经由优先审查程序批准。目前，勃林格殷格翰已向EMA及亚洲和其他国家监管当局提交了afatinib的监管审批，用于EGFR突变阳性的局部晚期和转移性NSCLC的治疗。

Afatinib的获批，是基于全面性的LUX-Lung临床试验项目。在NSCLC患者中开展的关键性LUX-Lung 3临床试验数据，证明了afatinib在携带EGFR突变的IIIb或IV阶段肺腺癌患者中相对于业界最佳化疗药物（培美曲塞和顺铂）的优越性。

试验中，将Afatinib作为一线治疗药物对患者进行了治疗，afatinib患者组疾病无进展生存期（PFS）为11.1个月，而化疗组（培美曲塞/顺铂）PFS为6.9个月。此外，针对携带2种最常见的EGFR突变（del19和L858R）的NSCLC，afatinib患者组PFS达13.6个月，而对照组仅为6.9个月。

Afatinib治疗组疾病进展延迟，患者大都经历了呼吸困难、气短、咳嗽、胸痛等症状的改善，Afatinib也显着延迟了这些症状的恶化。

Afatinib是勃林格殷格翰首个肿瘤学药物，是首个不可逆ErbB家族阻断剂，该药积极的临床证据，加上全新的作用模式，使其成为一种杰出的治疗选择，有望为肺癌患者提供其急需的临床需求。

英文原文：U.S. FDA approves Gilotrif? (afatinib)* as first-line treatment for lung cancer patients with EGFR mutations

Ingelheim, Germany, 15 July 2013 – Boehringer Ingelheim announced today that the U.S. Food and Drug Administration (FDA) has approved afatinib tablets under the U.S. brand name GILOTRIFTM for oral use, as a new first-line treatment for patients with metastatic non-small cell lung cancer (NSCLC) whose tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations as detected by an FDA-approved test.2

Lung cancer is the biggest cancer killer in the world with incidence rates higher in men than in women, it accounts for 1.6 million new cancer cases annually.3 However, lung cancer isn’t just one disease; research has shown there are many different types requiring specific treatment approaches. One distinct subtype of lung cancer is defined by mutations in EGFR (a member of the ErbB Family of receptors). These are patients that in clinical trials have been shown to benefit most from afatinib treatment.

"We are delighted to announce the first approval of afatinib, offering a new personalised treatment approach for patients with EGFR mutation positive NSCLC," said Prof Klaus Dugi, Corporate Senior Vice President Medicine, Boehringer Ingelheim. "It marks the first of what we hope will be many products to emerge from our oncology research and development programme, and underscores our continued commitment to translating innovative science into new treatment options for patients."

In the U.S., afatinib received orphan drug status and was assessed under the FDA’s priority review programme, which provides an expedited review for drugs that may provide safe and effective therapy when no satisfactory alternative therapy exists, or offer significant improvement compared to marketed products. Boehringer Ingelheim strives to make afatinib available to patients around the world. Afatinib has been submitted to the EMA and regulatory authorities in Asia and other countries for treatment of EGFR mutation positive locally advanced and metastatic NSCLC.

The approval of afatinib in the U.S. is based on data from the pivotal LUX-Lung 3 trial, comparing afatinib to chemotherapy with pemetrexed/cisplatin. Data from LUX-Lung 3 has shown that patients taking afatinib as a first-line treatment lived for almost one year without their tumour growing again (median progression-free survival (PFS) of 11.1 months) versus just over half a year (PFS of 6.9 months) for those treated with pemetrexed/cisplatin. In addition, NSCLC patients with tumours harbouring the two most common EGFR mutations (Del19 or L858R) taking afatinib lived for well over a year without tumour progression (PFS of 13.6 months) versus just over half a year (PFS of 6.9 months) for those in the comparator arm.1

In addition, patients taking afatinib also experienced an improvement in lung cancer symptoms and a better quality of life compared to those receiving standard chemotherapy treatment.

The most common grade 3 drug-related adverse events observed in the afatinib treatment arm were diarrhoea (14%), rash (16%), and inflammation of the nail bed (paronychia) (11%). The most common drug-related grade 3 adverse events observed in the chemotherapy arm (pemetrexed/cisplatin) were neutropenia (15%), fatigue (13%), and leucopenia (8%). There was a low discontinuation rate associated with treatment-related adverse events in the trial (8% discontinuation rate for afatinib; 12% for chemotherapy). One percent of patients in the afatinib arm discontinued due to drug-related diarrhoea.