title: The safety of afatinib for the treatment of non-small cell lung cancer.
abstract: Lung cancer tumors present EGFR mutations associated with an increased response rate to tyrosine kinase inhibitors (TKIs). Afatinib acts as an irreversible pan-ErbB-TKI. Areas covered: This review summarizes the results of clinical trials in NSCLC regarding its safety and efficacy. Expert opinion: Afatinib in 40 mg doses is highly effective in patients with NSCLC and EGFR mutations, improving progression-free survival and disease-related symptoms compared to chemotherapy. Additionally, afatinib has a better response rate and shows a small benefit in progression free survival compared to first-generation TKIs, and patients with exon 19 deletion could represent a subgroup with better prognosis and overall survival. Diarrhea, mucositis and rash are frequent adverse events induced by afatinib, these can impair quality of life and sometimes afatinib discontinuation is necessary. Management of adverse events, including early antidiarrheal treatment and prophylactic or early antibiotic management can reduce the gastrointestinal and cutaneous adverse events, respectively. Different risk factors, including malnourishment, sarcopenia, and low body surface might be associated with a higher toxicity risk, and these groups of patients could begin treatment with a low dose of afatinib followed by a close evaluation on tolerability and toxicity in order to slowly increase the dosage of afatinib.
authors.affiliation: a Thoracic Oncology Unit , Instituto Nacional de Cancerología , Mexico City , Mexico.
authors.forename: Feliciano
authors.initials: F
authors.lastname: Barron
authors.affiliation: a Thoracic Oncology Unit , Instituto Nacional de Cancerología , Mexico City , Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: de la Torre-Vallejo
authors.affiliation: a Thoracic Oncology Unit , Instituto Nacional de Cancerología , Mexico City , Mexico.
authors.forename: Rosa Luz
authors.initials: RL
authors.lastname: Luna-Palencia
authors.affiliation: b Clinical and Translational Oncology Group, Institute of Oncology , Clínica del Country , Bogota , Colombia.
authors.forename: Andres F
authors.initials: AF
authors.lastname: Cardona
authors.affiliation: a Thoracic Oncology Unit , Instituto Nacional de Cancerología , Mexico City , Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arrieta
mesh_terms: D000077716:Afatinib; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D018572:Disease-Free Survival; D066246:ErbB Receptors; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D011788:Quality of Life; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077716:Afatinib; D066246:ErbB Receptors
keywords: Afatinib; BIBW 2992; adverse effects; lung; neoplasms; oncology