Chou Chun-Liang, Ko How-Wen, Wang Chih-Wei, Yu Chih-Teng, Kuo Han-Pin, Huang Chien-Da
Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2010 Jan-Feb;33(1):100-5.
Erlotinib (Tarceva) is a human epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor used for treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after failure of at least one prior chemotherapy regimen. Interstitial lung disease, associated with gefitinib (Iressa) use, has been reported in approximately 1% of patients worldwide. However, the adverse pulmonary effects of erlotinib remain poorly documented. Reviewed English language publications in MEDLINE and PubMed suggest that this report is to be the first case report in English of a histologically-confirmed case of near-fatal interstitial pneumonitis with acute lung injury, associated with erlotinib, in East Asian patients. Physicians are hereby encouraged to promptly evaluate new or worsening pulmonary symptoms so that they can detect early radiographic signs of pulmonary toxicity in patients on erlotinib. If toxicity is confirmed, erlotinib should be discontinued and the patient treated appropriately. The case presented suggests that the outcome of erlotinib-associated pulmonary toxicity with acute respiratory failure may be favorable with adequate early management.
厄洛替尼（特罗凯）是一种人表皮生长因子受体（EGFR）酪氨酸激酶抑制剂，用于治疗至少一种先前化疗方案失败后的局部晚期或转移性非小细胞肺癌（NSCLC）。全球约1%使用吉非替尼（易瑞沙）的患者曾报告发生过间质性肺病。然而，厄洛替尼的肺部不良反应仍缺乏充分记录。检索MEDLINE和PubMed中的英文出版物表明，本报告是东亚患者中首例经组织学确诊的与厄洛替尼相关的近乎致命的急性肺损伤间质性肺炎的英文病例报告。特此鼓励医生及时评估新出现的或加重的肺部症状，以便在使用厄洛替尼的患者中发现早期肺部毒性的影像学征象。如果毒性得到确认，应停用厄洛替尼并对患者进行适当治疗。所呈现的病例表明，对于伴有急性呼吸衰竭的厄洛替尼相关肺部毒性，早期进行充分管理可能会有良好的预后。
