Abstract
Lung cancer is the leading cause of death among malignant tumours, most patients presenting in the metastatic stage IV. Therapy of this stage consists mainly in systemic palliative treatment.
The required standard for all adenocarcinomas includes investigation to determine the molecular profile of activating EGFR mutations as targeted treatment with some of the small molecule tyrosine kinase inhibitors (gefitinib, erlotinib, afatinib) in patients with positivity of this mutation results in approximately 60% response rate and significantly extended survival. Afatinib is a new selective irreversible inhibitor not only of EGFR, but of the whole ErbB family.
Two randomized trials of afatinib have shown significantly better efficacy in terms of higher rates of treatment responses and extended progression- -free survival in the range of 11.1-13.8 months as determined according to predefined diagnostic subgroups, as compared with a standard platinum-based cytostatic combination. Based on these results, it was approved for administration to EGFR TKI-naïve patients with non-small- -cell lung carcinoma with activating mutations of the epidermal growth factor receptor (EGFR).
Ongoing studies compare afatinib with other TKI EGFRs.