Afatinib is an oral tyrosine kinase inhibitor (TKI) that inhibit Endothelial Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. The common side effects of EGFR TKI are rash, acne, diarrhea, stomatitis, pruritus, nausea, and loss of appetite. Drug induced pneumonitis is the less common adverse effects of EGFR TKI. Afatinib, 2nd generation EGFR TKI is anticipated to overcome drug resistance from 1st generation EGFR TKI according to preclinical study, and several studies are being conducted to compare clinical efficacy between 1st and 2nd EGFR TKI. Several cases of rug induced acute fatal pneumonitis were reported after use of erlotinib or gefitinib. However, a case of acute fatal pneumonitis associated with afatinib was note reported except drug induced pneumonitis in other clinical study. Here, we present a cases of acute severe pneumonitis related with afatinib in metastatic lung adenocarcinoma with literature review.

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• Life‐threatening pneumonitis after first‐line treatment with osimertinib for primary T790M mutated non‐small cell lung cancer
  Maik Häntschel, Johannes Niebling, Almut Häring, Max‐Felix Häring, Thorben Groß, Marius Horger, Reimer Riessen, Michael Haap, Richard A Lewis, Michael Böckeler, Jürgen Hetzel
  Thoracic Cancer.2020; 11(7): 2044.     CrossRef
• Afatinib Associated Papulopustular Phototoxic Eruptions- A Novel Case Report
  U. Zeenath Begum, M. Krishnakanth, Gayathri Rajesh, Mahalakshmi Veeraraghavan, Sudha R, S. Murugan
  Biomedical and Pharmacology Journal.2019; 12(04): 1775.     CrossRef
• The Relative Risk and Incidence of Immune Checkpoint Inhibitors Related Pneumonitis in Patients With Advanced Cancer: A Meta-Analysis
  Ke Ma, Yali Lu, Shanshan Jiang, Jiangong Tang, Xin Li, Yuyang Zhang
  Frontiers in Pharmacology.2018;[Epub]     CrossRef
• Pneumonitis After Precision Oncology Therapies: A Concise Review
  Akash Jain, Vickie R. Shannon, Ajay Sheshadri
  Journal of Immunotherapy and Precision Oncology.2018; 1(1): 26.     CrossRef
• Treatment with a programmed cell death-1-specific antibody has little effect on afatinib- and naphthalene-induced acute pneumonitis in mice
  Naoki Hamada, Toyoshi Yanagihara, Kunihiro Suzuki, Saiko Ogata-Suetsugu, Eiji Harada, Hironori Mikumo, Masako Arimura-Omori, Yoichi Nakanishi
  Biochemical and Biophysical Research Communications.2017; 491(3): 656.     CrossRef