Afatinib for Advanced EGFR-Mutation Lung Cancer

Afatinib is an irreversible, oral, ErbB-family tyrosine kinase inhibitor (TKI) that has potential activity against epidermal growth factor receptor (EGFR)-mutation–driven non–small-cell lung cancer (NSCLC). To compare the efficacy of frontline afatinib versus chemotherapy with cisplatin plus pemetrexed in this setting, investigators conducted a global, phase III, randomized, open-label study (LUX-Lung 3) involving 345 EGFR-mutation patients with treatment-naïve, stage IIIB–IV disease.

Patients were randomized 2:1 to afatinib (40 mg daily) or cisplatin plus pemetrexed (standard doses every 21 days for ≤6 cycles) and stratified by mutation type or Asian ethnicity. A key limitation was the lack of maintenance pemetrexed in the chemotherapy arm,…