Gilotrif (afatinib)

Given the molecular findings & the symptoms, I would consider starting EGFR-TKI Tx if approved by insurance A case report of a patient with de novo SCLC (!) harboring the same mutations suggests sensitivity to afatinib (published in our beloved CLC 😀) https://t.co/GT4iWvosF6 (@chulkimMD)

Dr. Pasi Janne discusses the current standards with #EGFR NSCLC. Varies by mutation - osimertinib for del19 and L858R but afatinib for uncommon (though osi also active) and amivantamab or mobocertinib for ex20ins. Will we see a shift in the near future to SOC? #RomeLung23 (@StephenVLiu)

⛳️Afatinib and osimertinib have similar activities in uncommon EGFR mutated lung cancer. Here the article based on pooled analysis.👇 https://t.co/jhQUm5EE0z @OncoAlert @OncJournal (@yekeduz_emre)

In our new Publication Perspective video, based on a review, @StephenVLiu, on behalf of his co-authors, discusses the role of afatinib and other ErbB-targeting agents for NRG1 fusion-driven tumors. Watch the video: 📽️ https://t.co/5rg28nNHVM #NRG1 #NSCLC #LCSM #lungcancer (@VJofBiomedicine)

Afatinib effective in EGFR+ NSCLC and all comers SqNSCLC, so, that happened (@nativbklyn24)

Afatinib for an EGFR exon 20 insertion mutation: A case report of progressive stage IV metastatic lung adenocarcinoma with 54 months' survival https://t.co/3I9bzLqtlb (@drfeelgood049)

Retrospective analysis of osimertinib in 50 pts with atypical #EGFR NSCLC in #JTOCRR. Median time to d/c 17.2m for L861Q, 7.8m for G719X, 1.5m for exon 20 insertion. Afatinib is the approved standard for atypical; amivantamab and mobocertinib for ex20ins. https://t.co/kQiqpEJYTZ (@StephenVLiu)

Real-world data with afatinib in Spanish patients with treatment-naïve non-small-cell lung cancer harboring exon 19 deletions in epidermal growth factor receptor (Del19 EGFR): Clinical experience of the Galician Lung Cancer Group https://t.co/feIIxBSq30 (@mlazqui)

The article describing the @mybsmo #PrecisionMedicine initiative presents the case of a patient with metastatic pancreatic cancer harboring an EGFR mutation 🧬 and achieving a prolonged response on afatinib 💊 in the Precision 2 - afatinib "basket" study https://t.co/EBjvK54I1C (@aftimosp)

Excelente plática "El Rol de Afatinib en el manejo del CPCNP EGFR+" impartida por @ogarrieta y @JeronimoRdzCid #lungcancer #NSCLC Felicidades a todo el equipo de la @UToracica por su nueva investigación en proceso de publicación @LuisLara_M @DHeredia_onco @maritza_rramos (@JEGAYTAN90)

Afatinib in front line for uncommon mutations seem to do better for egfr positive #lungcancer says Dr Leighl with moderator ⁦@marinagarassino⁩ ⁦@gotoPER⁩ #ilcc #hb ⁦@IASLC⁩ ⁦@GO2Foundation⁩ ⁦@pmcancercentre⁩ ⁦@UCCancerCenter⁩ #lcsm use NGS (@donnashort)

More on the prognostic value of #ctDNA changes with targeted therapy for NSCLC @CCR_AACR. In @SWOG S1403 (1L afatinib +/- cetuximab for #EGFR NSCLC), clearance of EGFR ctDNA by 8w associated with better PFS (15.1 vs 4.6m, HR 0.23) and OS (HR 0.44). #LCSM https://t.co/UCJ96tw7KY (@StephenVLiu)

Complete Remission to Afatinib in a Patient Harboring a Novel Epidermal Growth Factor Mutation in De Novo Small-Cell Lung Cancer: A Case Report https://t.co/4BWF4FhjrC (@AndresFCardonaZ)

Osi given brain mets; but could argue for Afatinib too, given SRS to brain for good control. Overexpression of HER2 rather than mutation. If not brain mets, would go for afatinib. Or relevant HER2 OP trial (@OncoloJo)

One of the few pts I have treated who had primary progression on EGFR TKI (afatinib) had this scenario, I first saw pt just prior to Christmas & pt was deceased from tumor PD by Feb. With brain Mets would favor osimertinib but watch closely & consider chemo earlier than usual. (@FordePatrick)

Technically enhertu would be best in class HER2 directed mAb with CNS benefit. I think osi best here due to CNS+. Afatinib would be molecularly ideal but lack of CNS activity will be problem if brain Mets at baseline (@PatelOncology)

Osimertinib due to brain Mets (if no brain Mets I would pick afatinib for HER2 effect) (@PatelOncology)

Afatinib for the Treatment of Non-Small Cell Lung Cancer Harboring Uncommon EGFR Mutations: An Updated Database of 1023 Cases Brief Report #LCSM https://t.co/oIasOEThlj (@APassaroMD)

Updated database of > 1,000 patients w/uncommon #EGFR mutations. Afatinib a good 1st line option with ORR close to 50% & activity seen w/specific #exon20 insertion mutations. This highlights the heterogeneity of uncommon mutations! Congrats @APassaroMD & team #LCSM @EGFRResisters (@jillfeldman4)

📄 New article: Afatinib for the Treatment of NSCLC Harboring Uncommon EGFR Mutations: An Updated Database of 1023 Cases Brief Report 👨‍⚕️👩‍⚕️ James Chih-Hsin Yang et al. Read here 👉 https://t.co/R1y9kCEW7R @DrEdKim @cityofhope @cityofhopeoc #NSCLC #LungCancer #LCsm #Oncology (@FrontOncology)

Any advice for NSCLC patients with FGFR whose Afatinib is non effective after a period of time please? (@SorieT3)

First-line FDA-approved therapies for EGFR-sensitizing mutations like exon 19 deletions include osimertinib as the preferred frontline treatment, followed by erlotinib, gefitini, afatinib, and dacomitinib @ZPiotrowskaMD @MassGeneralNews #lcsm https://t.co/h29AI609Uz (@OncLive)

#TTLC22 Large track record for effectively targeting #NRG1 fusions in NSCLC with the pan-ErbB TKI afatinib. Multiple case reports published and prospective study underway. #LCSM (@StephenVLiu)

#TTLC22 Dr. @MJGrantMD presents outcomes with a specific subset of #EGFR exon 19 deletion NSCLC: L747-A750>P. Accounts for ~4% of del19. The proline insertion subset had a worse prognosis. Potential role for afatinib in this subset? Preclinical support; needs clinical validation. (@StephenVLiu)

Just out in @LungCaJournal : Sequential afatinib ➡️ osimertinib in patients with EGFR mutation-positive NSCLC and acquired T790M: A global non-interventional study (UpSwinG) by @DrSanjayPopat & colleagues @EGFRResisters @EgfrUk 👇🏼 https://t.co/ZgpoHJRZNL (@LungCaJournal)

From our "Triple meeting" (AACR-NCI-EORTC) presentation: Second-Line Sotorasib Plus Afatinib for KRAS–Mutant NSCLC - The ASCO Post https://t.co/LX4jeySdWb (@drgandara)

A Phase 1b Study Evaluating the Combination of Sotorasib , a KRAS G12C Inhibitor, and Afatinib , a Pan ErbB Tyrosine Kinase Inhibitor, in Advanced KRAS p.G12C Mutated NSCLC @drgandara #Targets21 (@VivekSubbiah)

Other drugs have been studied in this setting before (Her2 Mutant #NSCLC) - T-DxD seems to provide an advantage over others (remember no direct comparison) > Afatinib > Neratinib > Dacomitinib > Neratinib > Pyrotinib > Poziotinib #LCSM @lcsmchat (@CharuAggarwalMD)

#WCLC21 Dr. Silvia Garcia-Roman with the phase Ib EPICAL trial of anti-EGF vaccination with afatinib for #EGFR mutant NSCLC. High RR and mPFS 17.4m but no comparator here. Immunogenic effect? Intriguing. But note 13% grade 5 (fatal) toxicity. That is concerning... (@StephenVLiu)

#WCLC21 Dr. Satoru Miura presents phase I study of afatinib + osimertinib post progression on osi in #EGFR mutant NSCLC (n=13). RR 8% and mPFS 2.4m. Not too promising and not sure I agree with conclusion that this is "tolerable" given the DLTs seen across dose levels. #LCSM (@StephenVLiu)

Phase I Study of Afatinib and Selumetinib in Patients with KRAS‐Mutated Colorectal, Non‐Small Cell Lung, and Pancreatic Cancer - Brummelen - 2021 - The Oncologist - Wiley Online Library https://t.co/cJBUUBFTqr (@weldeiry)

Report in #JTOCRR of afatinib + xentuzumab (IGF-ligand neutralizing monoclonal) in #EGFR mutant NSCLC post TKI (non T790M). Seemed safe but no responses noted. Targeting IGFR has been disappointing (recall Clovis CO-1686, rociletinib). @JTOonline @IASLC https://t.co/l23gUG7XMa (@StephenVLiu)

#ASCO21 Impressive cross-tumor efficacy of zenocutuzumab in #NRG1 fusion positive cancers. NSCLC RR 25% but many patients with a minor response also noted (light blue in this waterfall) including responses post-afatinib. #LCSM (@StephenVLiu)

#ASCO21 Afatinib has some activity and 7/25 pts in the NSCLC cohort had received prior afatinib. Many different fusion partners (ultimately, this may be significant). Also note that RNA-seq is the best way to find #NRG1 fusions (massive gene, huge intronic regions). (@StephenVLiu)

EGFR-RAD51, what is the Tx? in 2017 i treated my first pt with afatinib successfully; now i have another one and the insurance still refuses to cover. What will you do? #LCSM @EGFRResisters @GO2Foundation @EgfrUk @EGFRSummit @DFEGFRcenter @GO2Foundation @LUNGevity @lcsmchat (@LuisERaez1)

New EGFR resistant mutation that might be target with afatinib @JennyCarlisleMD @EgfrUk @EGFRResisters @EGFRSummit @DFEGFRcenter @egfr @UPulmon #LCSM @LUNGFORCE @GO2Foundation @CAPLungCancer @lcfamerica @LUNGevity @GuardantHealth @Guardant360CDx https://t.co/krhygP9iy5 (@LuisERaez1)

#OncoAlert Report in #CLC of 4 pts with #EGFR mutant NSCLC with resistance to 1L osimertinib mediated by an acquired EGFR L718V (detected by plasma), 2 of whom responded to afatinib. #LCSM @LuisERaez1 @JennyCarlisleMD https://t.co/ReAbALXNfJ (@StephenVLiu)

#TTLC21 #NRG1 fusions are an emerging target best found with RNA-seq. Rare but detectable - see work by @SushmaJonna and actionable with targeting through the HER pathway. Ongoing trials of afatinib, tarloxotinib, zenocutuzumab, and seribantumab. #LCSM (@StephenVLiu)

Phase II study of afatinib x 2 years in EGFR MT NSCLC published in @ASCO_pubs #JCOPO today. With the results of #ADAURA, duration of adj TKI remains an important ? @JoelNealMD @LeciaSequist @n8pennell @ZPiotrowskaMD #LCSM @EGFRResisters (@CharuAggarwalMD)

Randomized Phase II Study of 3 Months or 2 Years of Adjuvant Afatinib in Patients With Surgically Resected Stage I-III EGFR Mutant Non–Small-Cell Lung Cancer #LCSM https://t.co/Ed6xnK63AG (@n8pennell)

As a slightly older oncologist I will take the side of afatinib as a slightly aging EGFR TKI here... amazing effort and data! Move aside durvalumab for stage 3 EGFR-mutated NSCLC- i want an EGFR TKI for my pt - young or slightly older (i mean the TKI...)😉 (@DrSteveMartin)

Check out @apipervallillo poster #WCLC20 on ASCENT trial: neoadjuvant afatinib, chemo/RT/surg, adj afat in pts with stage III EGFR mutant lung cancer. @ZPiotrowskaMD @HenningWillers @Dr_RayMak @JuliaRotow @OncoAlert @EGFRResisters #LCSM @MGHThoracicOnc 1/6 (@LeciaSequist)