Gilotrif (Afatinib) in Advanced Non-Small Cell Lung Cancer Patients Pre-treated With Erlotinib or Gefitinib

Inclusion Criteria: 1. Patients with pathologically confirmed diagnosis of adenocarcinoma of the lung Stage IV with progressive disease following at least one line of platinum-based cytotoxic chemotherapy 2. Patients progressing after clinical benefit on erlotinib or gefitinib: clinical benefit is defined as stable disease for at least 6 months, or a complete or partial response, or the presence of an activating mutation of the epidermal growth factor (EGF) receptor family. 3. No further treatment option is available. 4. Male and female patients age ≥18 years. 5. Written informed consent that is consistent with International Conference on Harmonisation-Good Clinical Practice (ICH-GCP) guidelines and local law. Exclusion Criteria: 1. Significant or recent acute gastrointestinal disorders with diarrhoea as a major symptom. 2. Patients who have any other life-threatening illness or organ system dysfunction, which in the opinion of the investigator, would compromise patient safety. 3. History of cardiac disease that is clinically significant, as judged by the investigator or uncontrolled cardiac disease (including congestive heart failure, angina, myocardial infarction, arrhythmia, including New York Heart Association (NYHA) functional classification of 3). 4. Aspartate amino transferase (AST) or alanine amino transferase (ALT) ≥ three times the upper limit of normal (if related to liver metastases ≥ five times the upper limit of normal). 5. Bilirubin ≥1.5 mg/dl 6. Serum creatinine ≥ 1.5 times of the upper normal limit or calculated/measured creatine clearance ≤ 45ml/min 7. Women of child-bearing potential or men who are able to father a child unwilling to use a medically acceptable method of contraception during the treatment. 8. Pregnancy or breast feeding. 9. Pre-existing Interstitial Lung Disease (ILD). 10. Patients suitable to be included into afatinib clinical trials