Moftakhar Bahar, Kharel Prakash, Niraula Sujan, Gandhi Shipra, Falkson Carla, Dhakal Ajay
Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA.
Geisinger Medical Center, Danville, PA, USA.
Breast Cancer (Auckl). 2020 Jun 23;14:1178223420935871. doi: 10.1177/1178223420935871. eCollection 2020.
We report a case of a 37-year-old woman who developed a duodenal ulcer while receiving adjuvant neratinib for HER2 positive breast cancer. The clinical course of abdominal pain was strongly correlated with the use of neratinib. An esophagogastroduodenoscopy (EGD) was performed and confirmed the diagnosis of a large duodenal ulcer. Neratinib was stopped, and the patient was treated with a proton pump inhibitor. Repeat EGD performed 3 months later showed complete resolution of the duodenal ulcer. Given this unexpected serious adverse event and only modest benefit of neratinib in the adjuvant setting, the decision was made to forgo further treatment with neratinib. Physicians should be aware of the gastrointestinal (GI) side effects associated with neratinib and recognize that peptic ulcer disease may be another GI toxicity associated with neratinib use.
我们报告了一例37岁女性，她在接受HER2阳性乳腺癌辅助奈拉替尼治疗时发生了十二指肠溃疡。腹痛的临床过程与奈拉替尼的使用密切相关。进行了食管胃十二指肠镜检查（EGD），确诊为巨大十二指肠溃疡。停用奈拉替尼，患者接受质子泵抑制剂治疗。3个月后复查EGD显示十二指肠溃疡完全愈合。鉴于这一意外的严重不良事件以及奈拉替尼在辅助治疗中的获益有限，决定不再继续使用奈拉替尼治疗。医生应意识到与奈拉替尼相关的胃肠道（GI）副作用，并认识到消化性溃疡病可能是与使用奈拉替尼相关的另一种胃肠道毒性。
