BACKGROUND: The combination of radiotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) has not been widely investigated. For afatinib, a new second generation irreversible pan-EGFR TKI, no clinical trials in this setting have as yet been performed. CASE REPORT: We report a patient with a pretreated metastatic NSCLC receiving afatinib in combination with concomitant palliative radiotherapy to the mediastinum and primary lung tumor. The treatment was feasible and well tolerated. The patient achieved a partial response in the irradiated tumor region and the metastatic sites. CONCLUSION: The combination of afatinib and radiotherapy is promising and should be investigated further. However, because of the limited experience and potential side effects known for other EGFR TKIs, a decision for treatment outside a clinical trial has to be made very carefully, balancing the risk and benefit on an individual patient basis.
BACKGROUND: The combination of radiotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) has not been widely investigated. For afatinib, a new second generation irreversible pan-EGFR TKI, no clinical trials in this setting have as yet been performed. CASE REPORT: We report a patient with a pretreated metastatic NSCLC receiving afatinib in combination with concomitant palliative radiotherapy to the mediastinum and primary lung tumor. The treatment was feasible and well tolerated. The patient achieved a partial response in the irradiated tumor region and the metastatic sites. CONCLUSION: The combination of afatinib and radiotherapy is promising and should be investigated further. However, because of the limited experience and potential side effects known for other EGFR TKIs, a decision for treatment outside a clinical trial has to be made very carefully, balancing the risk and benefit on an individual patient basis.