title: Second-line afatinib administration in an elderly patient with squamous cell carcinoma.
abstract: BACKGROUND
  The majority of cases of lung cancer are still diagnosed at a late stage. At this stage, palliative therapeutic options including nonspecific cytotoxic drugs, targeted therapy, or immunotherapy can be utilized. In 2016, immunotherapy was approved in Europe for squamous cell carcinoma and adenocarcinoma. Moreover, afatinib was also approved as second-line therapy for squamous cell carcinoma.
  
  
  METHODS
  This article presents a case of a 76-year-old male with squamous cell carcinoma who received nab-paclitaxel as first-line therapy, and his treatment was switched to the tyrosine kinase inhibitor afatinib (40 mg) after disease progression with left lung atelectasis. After receiving afatinib for only 28 days, the atelectasis resolved. No adverse effects were observed from the afatinib therapy.
  
  
  CONCLUSIONS
  In this case, afatinib 40 mg proved to be an effective alternative treatment for an elderly patient. Treatment choice should be based on the performance status of the patient, cost-effectiveness, and drug treatment guidelines.
authors.affiliation: Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hohenforst-Schmidt
authors.affiliation: Pulmonary Department - Oncology Unit, "G Papanikolaou" General Hospital, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Steinheimer
authors.affiliation: Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany.
authors.forename: Naim
authors.initials: N
authors.lastname: Benhassen
authors.affiliation: Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Sardeli
authors.affiliation: Pulmonary Department - Oncology Unit, "G Papanikolaou" General Hospital, Thessaloniki, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Stalikas
authors.affiliation: Pulmonary Department - Oncology Unit, "G Papanikolaou" General Hospital, Thessaloniki, Greece.
authors.forename: Melpomeni
authors.initials: M
authors.lastname: Toitou
authors.affiliation: Department of Respiratory and Critical Care Medicine, Changhai Hospital/First Affiliated Hospital of the Secondary Military Medical University, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Huang
keywords: EGFR; afatinib; lung cancer