@article{3103031,
    title = "An observational study to assess the molecular epidemiology and direct medical costs of epidermal growth factor receptor (Egfr) mutations in patients with advanced egfr mutation-positive non-small cell lung cancer treated with afatinib in real-world clinical settings in Greece",
    author = "Mountzios, G. and Lampaki, S. and Koliou, G.-A. and Vozikis, A. and Kontogiorgos, I. and Papantoniou, P. and Koufaki, M.I. and Res, E. and Boutis, A. and Christopoulou, A. and Pastelli, N. and Grivas, A. and Aravantinos, G. and Lalla, E. and Oikonomopoulos, G. and Koumarianou, A. and Spyratos, D. and Bafaloukos, D., Snr and Rigakos, G. and Papakotoulas, P. and Fountzilas, G. and Linardou, H.",
    journal = "Lung Cancer: Targets and Therapy",
    year = "2021",
    volume = "12",
    pages = "93-102",
    publisher = "Dove Medical Press Ltd",
    doi = "10.2147/LCTT.S318007",
    abstract = "Purpose: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the preferred first-line option for patients with advanced, EGFR-mutant non-small cell lung cancer (NSCLC). Afatinib, a second-generation irreversible EGFR-TKI, has been exten-sively used in Greece in this setting; however, real-world data regarding molecular epidemiology and financial implications of afatinib use are lacking. Materials and Methods: This was an observational, non-interventional, multicenter, retro-spective cohort study, based on real-world data collected from the medical charts/records of patients treated with afatinib between 15/03/2015 and 25/06/2020 and were recorded on a web-based data capture system. Cox models were used to assess the prognostic significance of clinicopathological parameters with respect to clinical outcomes of interest. Cost analysis was conducted from a public third-payer perspective, and only direct medical costs reim-bursed by the payer were considered. Results: A total of 59 patients were treated with afatinib for their EGFR mutation-positive advanced NSCLC; the median age was 61 years (range: 37–91). Performance status was zero in 61%, and brain metastases were present in 13.6%. Forty-four patients (74.6%) had a deletion in exon 19 only, while nine (15.3%) had a mutation in exon 21, 8 of them in L858R and one in L861Q. At a median follow-up of 41.8 months (95% CI 35.9–51.4), the median PFS was 14.3 months (95% CI 12.2–16.4), and the median OS was 29 months (95% CI 25.6–33.4). Corresponding values for patients with deletion 19 only were 14.3 months (95% CI 11.5–18.5) and 28.1 months (95% CI 21.1–32.6), respectively. The mean expendi-ture for the treatment of each patient equals €25,333.68; with €21,865.06 being attributed to drug acquisition costs, €3325.35 to monitoring costs and €143.27 to adverse event treatment-related costs. Conclusion: Long-term data in the real-world setting in Greece confirm activity, tolerability and cost-effectiveness of afatinib as first-line treatment of patients with advanced EGFR-mutant NSCLC. Clinical Trial Registration: Clinicaltrials.gov NCT04640870. © 2021 Mountzios et al."
}