MedPath

Afatinib

Generic Name
Afatinib
Brand Names
Gilotrif, Giotrif
Drug Type
Small Molecule
Chemical Formula
C24H25ClFN5O3
CAS Number
850140-72-6
Unique Ingredient Identifier
41UD74L59M
Background

Afatinib is a 4-anilinoquinazoline tyrosine kinase inhibitor in the form of a dimaleate salt available as Boehringer Ingelheim's brand name Gilotrif . For oral use, afatinib tablets are a first-line (initial) treatment for patients with metastatic non-small cell lung cancer (NSCLC) with common epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test . Gilotrif (afatinib) is the first FDA-approved oncology product from Boehringer Ingelheim .

Indication

Afatinib is a kinase inhibitor indicated as monotherapy for the first-line treatment of (a) Epidermal Growth Factor Receptor (EGFR) TKI (tyrosine kinase inhibitor)-naive adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) whose tumours have non-resistant EGFR mutations as detected by an FDA-approved test , and (b) adult patients with locally advanced or metastatic NSCLC of squamous histology progressing on or after platinum-based chemotherapy .

Recently, as of January 2018, the US FDA approved a supplemental New Drug Application for Boehringer Ingelheim's Gilotrif (afatinib) for the 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 . The new label includes data on three additional EGFR mutations: L861Q, G719X and S768I .

Associated Conditions
Metastatic Non-Small Cell Lung Cancer, Refractory, metastatic squamous cell Non-small cell lung cancer

Boehringer Ingelheim and Tessellate Bio Form €500M Partnership to Target ALT-Positive Cancers

• Boehringer Ingelheim has secured global commercialization rights for treatments co-developed with Tessellate Bio targeting tumors dependent on alternative lengthening of telomeres (ALT), present in 10-15% of all cancers. • The partnership, valued at over €500 million, aims to develop first-in-class oral precision therapies using synthetic lethality approaches for hard-to-treat cancers with poor prognosis and limited treatment options. • Tessellate Bio has developed inhibitors of an undisclosed target essential for ALT-positive cancer cell growth, which induce DNA damage and cell death specifically in cancer cells while sparing healthy tissue.

Local Therapy Boosts Outcomes in EGFR-Mutant NSCLC With Oligometastatic Disease

• Local consolidative therapy, such as stereotactic body radiation therapy (SBRT), may offer additional benefits in progression-free survival for patients with EGFR-mutant NSCLC. • The phase III SINDAS trial demonstrated that adding radiotherapy to first-generation EGFR-TKI therapy significantly improved PFS and overall survival in patients with oligometastatic EGFR-mutant NSCLC. • A phase II trial at ASCO 2024 showed promising results with osimertinib plus stereotactic ablative radiation (SABR), reporting a median PFS of 32.6 months and median OS of 45.7 months. • Ongoing trials like STEREO and NORTHSTAR are further evaluating the combination of EGFR TKIs with local therapy to improve outcomes in oligometastatic EGFR-mutant NSCLC.

Ribociclib Shows Promise in Advanced Breast Cancer Treatment

• Ribociclib, a CDK 4/6 inhibitor by Novartis, significantly improved progression-free survival when combined with letrozole in patients with hormone receptor-positive advanced breast cancer. • The MONALEESA-2 trial demonstrated a 63.0% progression-free survival rate at 18 months for ribociclib plus letrozole, compared to 42.2% with letrozole alone. • Common side effects of ribociclib include neutropenia, infection, hair loss, diarrhea, and nausea, with a small percentage of patients experiencing a prolonged QT interval. • Ribociclib's efficacy and potential high cost raise questions about its accessibility and how it compares to similar drugs like palbociclib.
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