Dr. Tolba on Targeting NRG1 Fusions With Afatinib

Khaled A. Tolba MD, MBBCh, assistant professor of medicine, School of Medicine, Oregon Health & Science University, discusses the potential to target NRG1 fusion—positive lung adenocarcinoma with afatinib (Gilotrif).

Approximately 17 cases of patients harboring a NRG1 chromosomal translocation treated with afatinib have been reported in the literature, says Tolba. At the 2019 World Conference on Lung Cancer, findings from a small case series showed that 4 patients with lung adenocarcinoma harboring an NRG1 fusion achieved a response or disease stabilization with afatinib.

Afatinib is a TKI that is commonly used to treat EGFR-mutant non—small cell lung cancer, says Tolba. As such, there is a lot of comfort in using the drug and managing any adverse events (AEs) that may result. Common AEs include skin rash and gastrointestinal toxicity, which can manifest as mouth sores and diarrhea. However, these toxicities can generally be managed with dose reductions, antibiotics, and skin care products, concludes Tolba.