Afatinib for Lung Cancer Progression After Erlotinib and Gefitinib

We do not know whether oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) can be sequenced after patients with non–small-cell lung cancer (NSCLC) experience disease progression during treatment with these agents.

Now, investigators in Japan have conducted a single-arm, open-label, phase II study (LUX-Lung 4) of the irreversible EGFR TKI afatinib (50 mg per day) in 61 evaluable patients with stage IIIB–IV NSCLC (45 were EGFR-mutation–positive). All patients had progressed after receiving ≥12 weeks of the reversible EGFR TKIs erlotinib, gefitinib, or both. Results were as follows:

• The objective response rate (the primary endpoint) was 8.2%.

• The percentage of patients achieving stable disease for ≥6 weeks was 57.4%.

• Med…