First-line afatinib in the real-world setting showed clinically meaningful effectiveness in patients with <i>EGFR</i>-mutant NSCLC and BM. CNS failure was a poor prognostic factor for TOT and OS correlating with younger age, poor ECOG PS, higher metastatic number, advanced disease stage, uncommon <i>EGFR</i> mutations, and baseline liver and/or bone metastases.