Efikasi Afatinib dan Gefitinib pada Pasien Non-small Cell Lung Cancer EGFR Mutasi Positif: Tinjauan Sistematis

Abstract

Tyrosine kinase inhibitors (TKIs) have been recommended by the National Comprehensive Cancer Networks (NCCN) as first-line therapy in non-small cell lung cancer (NSCLC) with EGFR mutation, namely gefitinib (first generation) and afatinib (second generation). Several studies have been conducted related to the efficacy of these TKIs, but few have conducted systematic reviews specifically afatinib and gefitinib. This systematic review aimed to provide a comprehensive overview of the efficacy of gefitinib and afatinib as first-line therapy. To identify the relevant studies, it used several databases such as Science Direct, PubMed, and Google Scholar. The review was limited to the randomized control trial study, the use of afatinib and gefitinib as first-line therapy, the use of afatinib and gefitinib as monotherapy, and articles written in the English language. An electronic data-based search identified 2089 articles; 48 articles matched the title and abstract, yet only 8 articles met the inclusion to be reviewed. In general, the efficacy of afatinib and gefitinib is more effective than platinum-based chemotherapy as showed that the progression-free survival of these medications is longer than platinum-based chemotherapy. Although the overall survival value is not better than platinum-based chemotherapy, afatinib inhibits the tumor growth better compared to gefitinib. Common side-effects in afatinib and gefitinib include rashes and diarrhea, while neutropenia, nausea, and anemia commonly occur in platinum-based chemotherapy. Afatinib and gefitinib offer better efficacy compared to platinum-based chemotherapy. Specifically, the afatinib has greater efficacy compared to gefitinib in first-line therapy for patient with NSCLC EGFR mutation. Keyword: Afatinib, efficacy, gefitinib, non-small cell lung cancer Korespondensi: Seftika Sari, MPH., Apt., Sekolah Tinggi Ilmu Farmasi Riau, Pekanbaru, Riau 28289, Indonesia, email: seftika1987.apt@gmail.com Naskah diterima: 9 Februari 2019, Diterima untuk diterbitkan: 15 Juli 2019, Diterbitkan: 28 Desember 2019 Jurnal Farmasi Klinik Indonesia, Desember 2019 Tersedia online pada: Vol. 8 No. 4, hlm 289–300 http://ijcp.or.id ISSN: 2252–6218 DOI: 10.15416/ijcp.2019.8.4.289 Jurnal Farmasi Klinik Indonesia Volume 8, Nomor 4, Desember 2019