Koma Yasuko, Matsuoka Hirofumi, Yoshimatsu Harukazu, Suzuki Yujiro
Department of Respiratory Medicine, Shinko Hospital, Kobe, Japan.
Int J Clin Pharmacol Ther. 2012 Oct;50(10):760-4. doi: 10.5414/CP201759.
Gefitinib and erlotinib, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), are widely used anticancer drugs for patients with non-small cell lung cancer (NSCLC), especially for those with EGFR-activating mutations. Both agents are considered to be less toxic compared with cytotoxic drugs; however, serious adverse events including interstitial lung disease (ILD) which can be fatal occur rarely. After such an event, physicians avoid to use another TKI. In such cases, patients and physicians are forced to make difficult decisions or reluctantly choose TKI when there is no other option. Here we report a case of a patient with lung adenocarcinoma who showed good recovery from gefitinib-induced ILD by high-dose corticosteroid therapy. The patient was then administrated erlotinib as second-line chemotherapy and showed tumor shrinkage without ILD after 6 months of treatment. We discuss the common features of the cases in the previous documentations and ours which were successfully retreated with erlotinib after gefitinib-induced ILD had previously developed.
吉非替尼和厄洛替尼作为表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs），是广泛用于非小细胞肺癌（NSCLC）患者的抗癌药物，尤其是对那些具有EGFR激活突变的患者。与细胞毒性药物相比，这两种药物都被认为毒性较小；然而，包括可能致命的间质性肺病（ILD）在内的严重不良事件很少发生。发生此类事件后，医生会避免使用另一种TKI。在这种情况下，患者和医生被迫做出艰难的决定，或者在没有其他选择时无奈地选择TKI。在此，我们报告一例肺腺癌患者，该患者通过大剂量皮质类固醇治疗从吉非替尼诱导的ILD中良好康复。该患者随后接受厄洛替尼作为二线化疗，治疗6个月后肿瘤缩小且未出现ILD。我们讨论了先前文献及我们的病例中，在先前发生吉非替尼诱导的ILD后成功接受厄洛替尼再次治疗的共同特征。
