Ansari Jawaher, Batubara Enas, Ali Muhammad, Farrag Ashraf, Bashir Farhat, Farghaly Hussein R, Ali Arwa M, Shaukat Arif
Department of Oncology, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
Department of Pulmonology, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
Mol Clin Oncol. 2018 Jul;9(1):92-95. doi: 10.3892/mco.2018.1620. Epub 2018 May 4.
Erlotinib is a first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) approved in the first-line treatment of advanced non-small-cell lung cancer (NSCLC) patients with sensitizing epidermal growth factor receptor (EGFR) mutations. The response rate to erlotinib is ~60% and the incidence of erlotinib-induced interstitial lung disease (ILD) is ~1-4%. The Response Evaluation Criteria in Solid Tumours (RECIST) tool is commonly used to assess response to erlotinib; however, evaluation of response and subsequent progression in the presence of atypical cystic lung changes may be challenging. We herein present a rare case of diffuse cystic lung changes secondary to erlotinib treatment in a patient with EGFR mutation-positive metastatic NSCLC. Challenges in assessing atypical tumour response to erlotinib, pitfalls in using RECIST and differential diagnosis of TKI-related ILD are discussed in detail.
厄洛替尼是第一代表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKI），被批准用于一线治疗具有敏感表皮生长因子受体（EGFR）突变的晚期非小细胞肺癌（NSCLC）患者。厄洛替尼的缓解率约为60%，厄洛替尼诱发的间质性肺病（ILD）发生率约为1%-4%。实体瘤疗效评价标准（RECIST）工具常用于评估对厄洛替尼的反应；然而，在存在非典型囊性肺改变的情况下评估反应及随后的进展可能具有挑战性。我们在此报告1例EGFR突变阳性转移性NSCLC患者在接受厄洛替尼治疗后出现弥漫性囊性肺改变的罕见病例。详细讨论了评估对厄洛替尼的非典型肿瘤反应的挑战、使用RECIST的陷阱以及TKI相关ILD的鉴别诊断。
