Afatinib              

Afatinib is a common first line choice in exon 18 mutations and treatment that is recommended by guidelines in many countries in uncommon mutations.

The main question these days is whether Afatinib or Osimertinib should be used in the first line in exon 18 mutations. The following comparison shows that Afatinib is superior to Osimertinib in exon 18 G719X mutation.

The following study shows very good efficacy of Afatinib: 

1240P - Targeting exon 18 EGFR alterations in non-small cell lung cancer: A patient-level analysis of published data  https://oncologypro.esmo.org/meeting-resources/esmo-congress-2021/targeting-exon-18-egfr-alterations-in-non-small-cell-lung-cancer-a-patient-level-analysis-of-published-data<br>