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Afatinib is an irreversible ErbB family (EGFR/HER) tyrosine kinase inhibitor, while letrozole is a nonsteroidal aromatase inhibitor. The combination of afatinib and letrozole has been investigated for the treatment of hormone receptor-positive, HER2-negative advanced or metastatic breast cancer, particularly in patients with low estrogen receptor expression or those who have progressed on prior endocrine therapy. The rationale for combining these agents is to overcome resistance to hormonal therapy by targeting both the estrogen signaling pathway and the ErbB/EGFR pathway[1][5][6].
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