afatinib afatinib afatinib, sold under the brand name gilotrif among others, is a medication used to treat non-small cell lung carcinoma (nsclc). it belongs to the tyrosine kinase inhibitor family of medications. it is taken by mouth. not to be confused with apatinib. afatinibclinical datatrade namesgilotrif, giotrif, afanixother namesbibw 2992ahfs/drugs.commonographmedlineplusa613044license data eu ema: by inn us dailymed: afatinib pregnancycategory au: c routes ofadministrationby mouthatc codel01eb03 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only uk: pom (prescription only) us: ℞-only eu: rx-only pharmacokinetic dataprotein binding95%metabolismcyp not involvedelimination half-life37 hoursexcretionfaeces (85%), urine (4%)identifiers iupac name n--7-oxy]-6-quinazolinyl]-4(dimethylamino)-2-butenamide cas number850140-72-6 ypubchem cid10184653iuphar/bps5667drugbankdb08916 ychemspider8360155 yunii41ud74l59mkeggd09724 nas salt: d09733 nchebichebi:61390 ychemblchembl1173655 ycomptox dashboard (epa)dtxsid20893451 echa infocard100.239.035 chemical and physical dataformulac24h25clfn5o3molar mass485.94 g·mol−13d model (jsmol)interactive image smiles cn(c)c\c=c\c(=o)nc3cc1c(nc(cc2cl)ccc2f)ncnc1cc3oc4cocc4 inchi inchi=1s/c24h25clfn5o3/c1-31(2)8-3-4-23(32)30-21-11-17-20(12-22(21)34-16-7-9-33-13-16)27-14-28-24(17)29-15-5-6-19(26)18(25)10-15/h3-6,10-12,14,16h,7-9,13h2,1-2h3,(h,30,32)(h,27,28,29)/b4-3+/t16-/m0/s1 ykey:ulxxddbfhobeha-cwdceqmosa-n y ny (what is this?) (verify) it is mainly used to treat cases of nsclc that harbour mutations in the epidermal growth factor receptor (egfr) gene. it is on the world health organization's list of essential medicines. medical uses it has received regulatory approval for use as a treatment for non-small cell lung cancer, although there is emerging evidence to support its use in other cancers such as breast cancer. adverse effects adverse effects by frequency include: very common (>10% frequency) diarrhea (>90%) rash/dermatitis acneform stomatitis paronychia decreased appetite nose bleed itchiness dry skin common (1–10% frequency) dehydration taste changes dry eye cystitis cheilitis fever runny/stuffy nose low amount of potassium in the blood conjunctivitis increased alt increased ast hand-foot syndrome muscle spasms kidney impairment and/or failure uncommon (0.1-1% frequency) keratitis interstitial lung disease mechanism of action like lapatinib and neratinib, afatinib is a protein kinase inhibitor that also irreversibly inhibits human epidermal growth factor receptor 2 (her2) and epidermal growth factor receptor (egfr) kinases. afatinib is not only active against egfr mutations targeted by first generation tyrosine-kinase inhibitors (tkis) like erlotinib or gefitinib, but also against less common mutations which are resistant to these drugs. however, it is not active against the t790m mutation which generally requires third generation drugs like osimertinib. because of its additional activity against her2, it is being investigated for breast cancer as well as other egfr and her2 driven cancers. afatinib covalently binds to cysteine number 797 of the epidermal growth factor receptor (egfr) via a michael addition (ic50 = 0.5 nm). clinical trials in march 2010, a phase iii trial in nsclc patients called lux-lung 5 began with this drug. fall 2010 interim results suggested the drug extended progression-free survival threefold compared to placebo, but did not extend overall survival. in may 2012, the phase iib/iii trial lux-lung 1 came to the same conclusion. in january 2015, a phase iii trial in people with nsclc suggested the drug extended life expectancy in stage iv nsclc adenocarcinoma with egfr mutation type del 19-positive tumors, compared to cisplatin-based chemotherapy by a year (33 months vs. 21 months). it also shows strong activity against exon 18 mutations (particularly g719) and is currently the preferred egfr-tki therapy for exon 18 mutations (particularly g719x). phase ii results for breast cancer that over-expresses the protein human epidermal growth factor receptor 2 (her2-positive breast cancer) were described as promising by the authors, with 19 of 41 patients achieving benefit from afatinib. double-blind phase iii trials are under way to confirm or refute this finding. her2-negative breast cancers showed limited or no response to the drug. society and culture brand names in bangladesh under the trade name afanix.