A trial looking at afatinib for non small cell lung cancer (ABLE)

Cancer type:

Lung cancer
Non small cell lung cancer




Phase 2

This trial is looking at a drug called afatinib before surgery for people with early stage non small cell lung cancer.

If it’s diagnosed early enough, doctors may treat non small cell lung cancer (NSCLC) with surgery. You may also have chemotherapy after your surgery. But there is a risk that your cancer could come back and researchers are looking for new treatments to try to stop this happening.

In this trial, they are looking at a drug called afatinib. It is a type of biological therapy that works by targeting a protein called epidermal growth factor receptor (EGFR).

The researchers want to see if having afatinib before surgery can help people with NSCLC.

The aims of the trial are to find out

  • How your cancer cells change through treatment with afatinib
  • If afatinib can shrink your tumour  before surgery
  • If the researchers can pick out particular genes and proteins linked to whether afatinib works well or not
  • More about the side effects

Who can enter

You may be able to join this trial if all of the following apply

  • You have non small cell cancer (NSCLC) that is stage 1 or stage 2 and can be completely removed with surgery
  • Your cancer can be seen on a scan and measures at least 8mm across
  • You can swallow tablets
  • You are well enough to carry out all your normal activities, apart from heavy physical work (performance status of 0 or 1)
  • You have satisfactory blood test results
  • You are at least 18 years old
  • You are willing to use reliable contraception during treatment and for up to 1 month afterwards if there is any chance that you or your partner could become pregnant

You cannot join this trial if any of these apply

  • Your cancer sample (biopsy) Open a glossary item shows that you have small cell lung cancer cells as well as non small cell lung cancer cells
  • You  have a type of tumour called a pulmonary carcinoid tumour or a large cell carcinoma (your doctor can tell you more about this)
  • Your scan shows that there is cancer in the lymph nodes Open a glossary item in the centre of your chest on the same side as the affected lung, or there is cancer in the lymph nodes just under where your windpipe branches off to each lung
  • You have had chemotherapy or radiotherapy for your NSCLC in the past
  • You have had a type of biological therapy that specifically target cells with EGF receptors Open a glossary item in the past
  • You are taking medication such as clarithromycin or ciclosporin (your doctors can tell you more about this)
  • You have had any other cancer apart from non melanoma skin cancer
  • You have a lung condition called interstitial lung disease
  • You have had problems with your digestive system Open a glossary item in the last 6 months that may interfere with how you absorb the trial drug
  • You have a serious heart problem
  • You have high blood pressure that can’t be controlled with medication
  • You are pregnant or breast feeding
  • You are hepatitis B,  hepatitis C or HIV positive
  • You have diabetes that can’t be controlled with medication
  • You use drugs or alcohol in a way that is cause for concern
  • You are known to be allergic to afatinib or anything it contains
  • You have a serious eye infection that you have had a for a long time and is not getting better with treatment
  • You are having any other treatment as part of a clinical trial
  • You have a blockage in the large vein that brings blood back to your heart (the superior vena cava)
  • You have any other medical condition or mental health problem that the trial team think would affect you taking part in this trial

Trial design

This is a phase 2 trial. The researchers need 60 people to join the trial. Everybody taking part will have afatinib for a few weeks before having surgery.

Afatinib is a tablet that you take once a day on an empty stomach. It is important to take it at least 1 hour before eating or at least 3 hours afterwards. You must not eat grapefruit or drink grapefruit juice as it may affect the way your body absorbs the drug.

You take afatininb until the day of your surgery for lung cancer. You have afatinib for about a month in total.

The researchers will ask to take a sample of your cancer (a biopsy Open a glossary item) before you start treatment. If you have already had a sample taken, the researchers can use the stored sample for their tests. They will compare this sample with a sample that is removed when you have your lung cancer surgery. This is to see if afatininb has helped to treat your lung cancer.

Hospital visits

You see the trial team and have some tests before you start treatment. The tests include

  • A physical examination
  • Heart trace (ECG Open a glossary item)
  • Chest X-ray
  • Blood tests
  • Urine test
  • CT scan and a PET-CT scan

You have a CT scan on the day you start taking afatinib (or a few days before). And then you have a PET-CT scan 2 weeks after that.

The trial team will see you a month after your surgery for a check up and a blood test. They will continue to check how you are when you have your routine appointments with your lung cancer doctor.

Side effects

The most common side effects of afatininb are

We have more information about the side effects of afatinib.



Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Clive Mulatero

Supported by

Boehringer Ingelheim
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
University of Leeds

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Over 60,000 cancer patients enrolled on clinical trials in the UK last year.

Last reviewed:

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