Afatinib Therapy: Practical Management of Adverse Events With an Oral Agent for Non-Small Cell Lung Cancer Treatment

Clin J Oncol Nurs. 2018 Oct 1;22(5):542-548. doi: 10.1188/18.CJON.542-548.

Abstract

Background: Afatinib is an oral, irreversible ErbB family blocker indicated for first-line treatment of metastatic non-small cell lung cancer (NSCLC) in patients with non-resistant epidermal growth factor receptor (EGFR) mutations. Afatinib is also approved for the treatment of metastatic squamous NSCLC following progression on platinum-based chemotherapy. Common afatinib-associated toxicities include gastrointestinal and dermatologic events, which can be dose limiting.

Objectives: In this review, the authors describe clinical trial experiences with afatinib, as well as best practices and practical approaches to the management of afatinib-associated adverse events in EGFR mutation-positive NSCLC.

Methods: Safety and tolerability data from phase 3 trials of afatinib were reviewed, together with real-life experiences from the authors' clinical practices.

Findings: Patient education, combined with early assessment and effective management of afatinib-related adverse events as well as dose- reduction strategies, allows patients to continue treatment and maximize the clinical benefits of afatinib.

Keywords: adverse events; afatinib; dose reduction; non-small cell lung cancer.

Publication types

  • Review

MeSH terms

  • Adult
  • Afatinib / therapeutic use*
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug-Related Side Effects and Adverse Reactions / drug therapy*
  • Education, Nursing, Continuing
  • ErbB Receptors / drug effects*
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Protein Kinase Inhibitors / therapeutic use*

Substances

  • Protein Kinase Inhibitors
  • Afatinib
  • ErbB Receptors