Polychronidou Genovefa, Papakotoulas Pavlos
Theagenio Cancer Hospital, Thessaloniki, Greece.
Case Rep Oncol. 2013 Mar 29;6(1):189-96. doi: 10.1159/000350680. Print 2013 Jan.
The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib are known to have greater efficacy in EGFR mutation-positive non-small cell lung cancer (NSCLC), although erlotinib also has activity in wild-type disease. We report the successful long-term maintenance treatment of a patient with EGFR wild-type NSCLC with gefitinib and later erlotinib. The patient (male; 44 years old; smoker) was diagnosed with EGFR wild-type NSCLC after computer tomography had revealed a mediastinal mass, and histology and mutation testing had identified the tumor as an EGFR wild-type grade 3 adenocarcinoma. The patient received multiple rounds of chemotherapy, followed by gefitinib maintenance (3 years). Later on, he received erlotinib maintenance and developed a persistent rash (grade 1/2) that lasted throughout the treatment. The patient's condition has remained stable on erlotinib for more than 5 years, with no evidence of progression. We describe the patient's disease course and treatment in the context of EGFR TKI therapy and the prognostic factors for long-term clinical outcomes of NSCLC, including the development of erlotinib-induced rash.
表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）吉非替尼和厄洛替尼在EGFR突变阳性的非小细胞肺癌（NSCLC）中疗效更佳，不过厄洛替尼在野生型疾病中也有活性。我们报告了1例EGFR野生型NSCLC患者先后使用吉非替尼和厄洛替尼进行长期维持治疗成功的病例。该患者（男性，44岁，吸烟者）经计算机断层扫描发现纵隔肿块后，被诊断为EGFR野生型NSCLC，组织学和突变检测确定肿瘤为EGFR野生型3级腺癌。患者接受了多轮化疗，随后接受吉非替尼维持治疗（3年）。之后，他接受厄洛替尼维持治疗，并出现了持续整个治疗过程的持续性皮疹（1/2级）。患者使用厄洛替尼治疗5年多来病情一直稳定，无进展迹象。我们结合EGFR TKI治疗以及NSCLC长期临床结局的预后因素，包括厄洛替尼诱发皮疹的情况，描述了该患者的病程及治疗过程。
