Park Eun Hye, Lee Hwa Young, Kim Jin Woo, Yeo Chang Dong
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
J Thorac Dis. 2017 Jun;9(6):E543-E546. doi: 10.21037/jtd.2017.05.10.
We report on a patient with lung adenocarcinoma and a concomitant epithelial growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocation who developed a disease flare after discontinuing gefitinib. A 63-year-old woman with lung adenocarcinoma and a concomitant activating EGFR mutation and ALK translocation was treated with first-line gefitinib. After 4 months, she discontinued the gefitinib due to disease progression. She was admitted to the emergency room complaining of severe dyspnea and back pain 22 days after discontinuing gefitinib. A chest image showed numerous hematogenous lung metastases and extensive bone metastasis, which was compatible with a previously reported disease flare after stopping EGFR tyrosine kinase inhibitors (TKIs). Aggravated respiratory failure and progression of multiple organ dysfunction led to death 26 days after discontinuing gefitinib. This was a rare case of a disease flare up in patient with a concomitant EGFR mutation and ALK translocation after discontinuing an EGFR-TKI.
我们报告了一例肺腺癌患者，该患者同时存在上皮生长因子受体（EGFR）突变和间变性淋巴瘤激酶（ALK）易位，在停用吉非替尼后病情出现 flare。一名63岁患有肺腺癌且同时存在激活型EGFR突变和ALK易位的女性接受了一线吉非替尼治疗。4个月后，由于疾病进展她停用了吉非替尼。在停用吉非替尼22天后，她因严重呼吸困难和背痛被送往急诊室。胸部影像显示有大量血行性肺转移和广泛骨转移，这与之前报道的停用EGFR酪氨酸激酶抑制剂（TKIs）后的病情 flare相符。停用吉非替尼26天后，严重呼吸衰竭和多器官功能障碍进展导致患者死亡。这是一例罕见的在同时存在EGFR突变和ALK易位的患者停用EGFR-TKI后出现病情 flare的病例。
