This retrospective analysis included 35 patients with histologically confirmed EGFR mutation‐positive advanced NSCLC receiving first‐line afatinib treatment between March 2017 and March 2019 at Beijing Hospital/National Center of Gerontology. Patients initially received afatinib 40 mg orally once a day. The treatment was continued until disease progression. In the case of grade ≥3 or certain prolonged grade 2 treatment‐related AEs, the afatinib dose was reduced from 40 to 30 mg and if required from 30 to 20 mg.

The tumor response was classified according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, as either complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Investigators used patients' medical records to collect details of baseline demographics, safety and effectiveness of afatinib. Incidence and severity of AEs were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE; version 5.0). The performance status was evaluated with Eastern Cooperative Oncology Group performance status (ECOG PS). Treatment modifications resulting from toxicity were evaluated, including dose reduction and termination of afatinib. PFS of afatinib was defined as the time from initiation of afatinib to RECIST‐defined PD or death from any causes. The cutoff follow‐up time for this study was August 1, 2020. The data were censored if patients had not progressed at the time of last follow‐up. The definition of non‐smokers was less than 100 cigarettes in their lifetime. EGFR mutation detection was carried out either by amplification‐refractory mutation system (ARMS) method or next generation sequencing (NGS) approach.

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