Afatinib (Gilotrif)

General information

Class/mechanism: Irreversible tyrosine kinase inhibitor of EGFR (epidermal growth factor receptor, ErbB1), HER2 (human epidermal growth factor receptor 2, ErbB2), and HER4 (human epidermal growth factor receptor 4, ErbB4). Inhibition of tyrosine kinase autophosphorylation inhibits ErbB signaling.

Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Head and neck cancer
• EGFRm non-small cell lung cancer

Patient drug information

• Afatinib (Gilotrif) package insert
• Afatinib (Gilotrif) patient drug information (Chemocare)
• Afatinib (Gilotrif) patient drug information (UpToDate)

History of changes in FDA indication

• 7/12/2013: Approved for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations as detected by an FDA-approved test.
• 4/15/2016: Approved for treatment of patients with metastatic, squamous NSCLC progressing after platinum-based chemotherapy.
• 1/12/2018: Approval expanded for a broadened indication in first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have non-resistant epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test.

Also known as

• Code names: BIBW 2992, BIBW-2992
• Brand names: Afanix, Gilotrif, Giotrif, Tomtovok, Tovok, Xovoltib