Afatinib for Patients With EGFR Mutation

Paul A. Bunn, Jr, MD, professor of medicine in medical oncology, head of the division of medical oncology, University of Colorado, discusses afatinib for patients with activating epidermal growth factor receptor (EGFR) mutation.

Afatinib is a second-generation tyrosine kinase inhibitor that binds to the activating mutations in EGFR and has been approved by the FDA, Bunn says. There is also an EGFR mutation test that goes with the drug.

Unlike erlotinib and gefitinib, afatinib binds to T790M, which could lead to a longer time to resistance. Afatinib is similar to erlotinib and gefitinib in that it can cause diarrhea and skin toxicities, Bunn says.

Bunn says while afatinib seems to be just as good as erlotinib and gefitinib, it has yet to be determined if it is better than those agents.

Clinical Pearls

• Afatinib is a second-generation EGFR TKI that was approved by the FDA
• Unlike erlotinib and gefitinib, afatinib binds to T709M
• Afatinib is similar to erlotinib and gefitinib in that it causes diarrhea and skin toxicities
• While afatinib seems to be just as good as erlotinib and gefinitib, it has yet to be determined if it is better.