BACKGROUND: Chordoma is a rare, but aggressive bone tumor, primarily affecting the axial skeleton. Systemic chemotherapies are not effective against the tumor, and treatment primarily consists of surgical resection and radiation. Despite these treatment modalities, recurrence is common. Our case highlights the role of afatinib as an effective treatment option in such cases.

CASE REPORT: We present case of 68-year-old female with chordoma, who underwent multiple surgical resections, radiotherapy session, and had course complication by disease progression on imatinib and local recurrence. She was eventually placed on afatinib with good effect.

CONCLUSIONS: This article discusses the effectiveness of afatanib as a treatment modality, along with diagnosis, histopathological features, associated genetic aberrations, currently available and upcoming treatment options. Special emphasis is placed on molecular targeted therapy, emerging immunotherapies and use of vaccination in this field.

Keywords: chordoma, Molecular Targeted Therapy, proton therapy, Afatinib, Combined Modality Therapy, Hoarseness, imatinib mesylate, Magnetic Resonance Imaging, Spinal Neoplasms