Afatinib-associated pancreatitis in a patient with lung cancer– A rare case report

Afatinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor used in EGFR-mutant non-small cell lung cancer (NSCLC). Although gastrointestinal adverse effects are common, pancreatitis is rarely reported. A 63-year-old woman with EGFR exon 21 L858R-mutant lung adenocarcinoma developed progressive gastrointestinal symptoms one month after starting afatinib. Laboratory tests showed markedly elevated pancreatic enzyme levels, while abdominal imaging revealed no typical findings of pancreatitis. Other common etiologies were excluded. Afatinib was discontinued, and supportive treatment resulted in clinical improvement and normalization of pancreatic enzymes. She was subsequently switched to erlotinib with stable disease. Afatinib-associated pancreatitis is an extremely rare adverse event that may occur without characteristic imaging abnormalities. Early recognition and discontinuation of the offending agent are essential.