Department of Radiation Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, PR China.
BMC Cancer. 2010 Feb 21;10:49. doi: 10.1186/1471-2407-10-49.
Gefitinib is one of the small molecule inhibitors of epidermal growth factor receptor tyrosine kinase (EGFR TKIs). Clinical trials have demonstrated it is effective for treatment of a subset of patients with advanced non-small cell lung cancer (NSCLC). Gefitinib has been generally considered to be a relatively safe agent. Besides a small proportion of fatal interstitial pneumonia, the common adverse drug reactions of gefitinib include diarrhea and skin rash, which are generally mild and reversible. Herein, we report the first two cases of brain metastasis hemorrhage that might be involved with the use of gefitinib.
Two patients with brain metastasis from NSCLC developed brain hemorrhage after gefitinib therapy. The hemorrhage in one case occurred one month after gefitinib combined with whole brain radiation therapy (WBRT), and in the another case hemorrhage developed slowly within brain metastases eight months post gefitinib monotherapy for diffuse pulmonary metastasis from a lung cancer undergone surgical removal previously.
We speculate brain hemorrhage could be one of the adverse drug reactions of gefitinib treatment for NSCLC and suggest clinicians be aware of this possible rare entity. More data are needed to confirm our findings, especially when gefitinib is used in the settings of brain metastases from NSCLC or other origins.
吉非替尼是一种表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）小分子抑制剂。临床试验表明，它对治疗晚期非小细胞肺癌（NSCLC）的一部分患者有效。吉非替尼通常被认为是一种相对安全的药物。除了一小部分致命性间质性肺炎外，吉非替尼的常见药物不良反应包括腹泻和皮疹，通常是轻微和可逆的。在此，我们报告了首例两例可能与吉非替尼使用相关的脑转移出血病例。
两名 NSCLC 脑转移患者在接受吉非替尼治疗后发生脑出血。一例患者在吉非替尼联合全脑放疗（WBRT）后一个月发生脑出血，另一例患者在先前接受手术切除的肺癌弥漫性肺转移后单独使用吉非替尼 8 个月后脑转移内缓慢发生出血。
我们推测脑出血可能是吉非替尼治疗 NSCLC 的药物不良反应之一，并建议临床医生注意这种可能的罕见情况。需要更多的数据来证实我们的发现，特别是当吉非替尼用于治疗 NSCLC 或其他来源的脑转移时。
