Hecimovic Ana, Vukic Dugac Andrea, Jankovic Makek Mateja, Cikes Maja, Samarzija Miroslav, Jakopovic Marko
Department for Lung Diseases, University Hospital Centre Zagreb.
Monaldi Arch Chest Dis. 2019 May 30;89(2). doi: 10.4081/monaldi.2019.1023.
Lung cancer incidence in heart transplant patients is higher than in general population and correlates with smoking history. EGFR-mutations are more frequent in adenocarcinoma and among non-smoking women but incidence in solid organ transplanted patients is still not known. We present case of a 65-year-old ex-smoker male with history of heart transplantation and EGFR positive metastatic lung adenocarcinoma. At admission he was in a severe clinical condition and treatment with erlotinib was started. Initially he had good clinical and radiologic response to treatment with only grade 1 side effects. Data about drug interactions between cyclosporine and erlotinib are insufficient but we have to take this interaction into consideration during treatment because both drugs are substrates and inhibitors of CYP34A. In our case erlotinib was safe and well tolerated drug, there were no relevant toxicity, but close monitoring and dose reduction of cyclosporine was needed.
心脏移植患者的肺癌发病率高于普通人群，且与吸烟史相关。表皮生长因子受体（EGFR）突变在腺癌以及非吸烟女性中更为常见，但实体器官移植患者中的发病率仍不清楚。我们报告了一例65岁有心脏移植史的戒烟男性患者，其患有EGFR阳性转移性肺腺癌。入院时他临床症状严重，遂开始使用厄洛替尼治疗。起初，他对治疗有良好的临床和影像学反应，仅出现1级副作用。关于环孢素和厄洛替尼之间药物相互作用的数据不足，但在治疗期间我们必须考虑这种相互作用，因为这两种药物都是细胞色素P450 3A（CYP34A）的底物和抑制剂。在我们的病例中，厄洛替尼是一种安全且耐受性良好的药物，没有相关毒性，但需要密切监测并减少环孢素的剂量。
