Genomic Analysis of Tumors from Patients with Glioblastoma with Long-Term Response to Afatinib

Scott Owen,1 Scheryll Alken,2,3 Jad Alshami,1 Marie-Christine Guiot,1,4 Petr Kavan,1 David A Reardon,5 Thierry Muanza,1,4,6 Neil Gibson,7 Karine Pemberton,8 Flavio Solca,9 Agnieszka Cseh10 ,†Frank Saran2,11 1Clinical Research Unit, Montreal Neurological Institute and Hospital, McGill University Health Center, Montreal, Canada; 2Radiation Oncology Unit, Royal Marsden Hospital, London, UK; 3St James’s Hospital, Dublin, Ireland; 4Neuropathology Division, Montreal Neurological Institute and Hospital, McGill University Health Center, Montreal, Canada; 5Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; 6Radiation Oncology, Jewish General Hospital, Montreal, Canada; 7Drug Metabolism & Pharmacokinetics, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany; 8Medical Department, Boehringer Ingelheim Ltd., Bracknell, UK; 9Department of Pharmacology, Boehringer Ingelheim RCV GmbH & Co. KG, Vienna, Austria; 10Department of Medical Affairs, Boehringer Ingelheim International, Ingelheim am Rhein, Germany; 11Department of Blood and Cancer, Auckland City Hospital, Auckland, New Zealand†Agnieszka Cseh passed away in May 2021Correspondence: Frank Saran, Auckland City Hospital, Cancer and Blood Service, Building 8, 99 Park Road, Grafton, Private Bag 92024, Auckland, 1142, New Zealand, Tel +64 09 623 6046, Email FSaran@adhb.govt.nzAbstract: Glioblastoma is an aggressive form of central nervous system tumor. Recurrence rates following primary therapy are high, and few second-line treatment options provide durable clinical benefit. Aberrations of the epidermal growth factor receptor (EGFR) gene are observed in up to 57% of glioblastoma cases and EGFR overexpression has been identified in approximately 60% of primary glioblastomas. In preclinical studies, afatinib, a second-generation ErbB blocker, inhibited cell proliferation in cells harboring mutations commonly found in glioblastoma. In two previous Phase I/II studies of afatinib plus t