Adverse event management: stomatitis
- Continue GIOTRIF® (afatinib) treatment at current dose
Grade ≥3 or intolerable Grade 2:
- Interrupt GIOTRIF® (afatinib), resuming treatment at a reduced dose (10 mg lower) if patient recovers to grade ≤1. Permanent discontinuation should be considered in patients who cannot tolerate 20 mg/day of GIOTRIF® (afatinib) treatment
- Stomatitis may be managed through palliation with: bland saline rinses, topical lidocaine anaesthetics, mucosal coating agents or analgesics
- This choice of management should be driven by patient preference
Advice for patients2-4
- Brush teeth and gums gently with a soft toothbrush and rinse with warm salt water, after every meal and before bed. Avoid alcohol-based mouthwashes
- Eat foods cold or at room temperature; hot and warm food can irritate a tender mouth
- Avoid acidic, spicy or salty juices and food which may irritate the mouth. Also avoid foods which require a lot of chewing
- Drink plenty of water and use a straw to drink liquids
- Use lip balm or petroleum jelly for dry lips
- When needed, numb the mouth with ice chips or flavoured ice blocks
Adapted from CTCAE version 3.5
CTCAE=common terminology criteria for adverse events
- GIOTRIF® (afatinib) Summary of Product Characteristics, 2018.
- Bensinger W, et al. J Natl Compr Canc Netw 2008;6(Suppl 1):S1-21.
- Gupta A, West H. JAMA Oncol 2016;2(10):1379.
- Aw DC, et al. Asia-Pac J Clin Oncol 2018;14(1):23–31.
- Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0.