newly diagnosed NSCLC stage 4 EGFR positive - 1274617

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schmeggs
newly diagnosed NSCLC stage 4 EGFR positive - 1274617

I have the option of going off study or joining a study comparing afatinib vs afatinib with
cetuximab IV (more rash?). Is there any benefit to the combination or should I consider getting Tarceva or Gilotrif off study? Thank you.

JimC
Hi schmeggs,

Hi schmeggs,

The afatinib/cetuximab combination has been used mostly in the setting of second-line treatment for acquired resistance to an EGFR inhibitor such as Tarceva, where it does show some efficacy, albeit with fairly significant toxicities. Single-agent afatinib does not provide much benefit in that second-line setting.

Afatinib doesn't seem to be better than Tarceva in the first line setting (In this post, Dr. West called it "a more toxic version of ... already available agents"), so there doesn't seem to be much reason to prefer it in that context.

Since the afatinib/cetuximab combination does show efficacy for patients with acquired resistance, starting with Tarceva does preserve that option. Dr. West discusses that regimen here. Dr. West discusses other options for acquired resistance here and it's discussed in many other posts on this site, which you can find by searching for "acquired resistance".

JimC
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<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>