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阿帕替尼治疗后肺癌并发气胸:1 例报告。

Pneumothorax in lung cancer following anlotinib treatment: A case report.

机构信息

Department of Respiratory and Critical Care Medicine, The First People's Hospital of Neijiang, China.

出版信息

Medicine (Baltimore). 2022 Jul 22;101(29):e29273. doi: 10.1097/MD.0000000000029273.

Abstract

RATIONALE

Anlotinib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor, and has been approved for the treatment of patients with advanced nonsmall cell lung cancer who had received at least 2 previous chemotherapy and epidermal growth factor receptor/anaplastic lymphoma kinase targeted therapy regimens. Pneumothorax is a rare adverse reaction of this drug. Here, we present a case of pneumothorax following anlotinib treatment in a patient with lung cancer.

PATIENT CONCERNS

A 61-year-old Asian male long-term smoker was admitted to the hospital in November 2019 with sputum production and dyspnea.

DIAGNOSIS

The patient was diagnosed with right lung adenocarcinoma with mediastinal and rib metastases, combined with chronic obstructive pulmonary disease and pulmonary bullous disease.

INTERVENTIONS

The patient was treated with oral administration of anlotinib. The patient had a recurrent pneumothorax that improved after drug withdrawal and was free of recurrence. Therefore, pneumothorax caused by rupture of the pulmonary bullous due to anlotinib was considered.

OUTCOMES

After discontinuing anlotinib, the patient has not developed pneumothorax to date.

LESSONS

Pneumothorax may occur when VEGF is inhibited, which can promote the proliferation and repair of alveolar wall substances, leading to alveolar rupture. With respect to pneumothorax, it is necessary to be aware of the risk of pulmonary bullous rupture during antitumor treatment with small-molecule tyrosine kinase drugs.

摘要

理由

安罗替尼是一种针对血管内皮生长因子受体的口服酪氨酸激酶抑制剂,已被批准用于治疗接受至少 2 种先前化疗和表皮生长因子受体/间变性淋巴瘤激酶靶向治疗方案的晚期非小细胞肺癌患者。气胸是该药的一种罕见不良反应。在这里,我们报告了 1 例肺癌患者在接受安罗替尼治疗后发生气胸的病例。

患者关注

一名 61 岁的亚洲男性长期吸烟者于 2019 年 11 月因咳痰和呼吸困难入院。

诊断

患者被诊断为右肺腺癌伴纵隔和肋骨转移,合并慢性阻塞性肺疾病和肺大疱病。

干预

患者接受安罗替尼口服治疗。患者出现复发性气胸,停药后改善,无复发。因此,考虑为安罗替尼引起的肺大疱破裂所致气胸。

结果

停用安罗替尼后,患者迄今未发生气胸。

教训

抑制 VEGF 可能会导致气胸,这可以促进肺泡壁物质的增殖和修复,导致肺泡破裂。对于气胸,在使用小分子酪氨酸激酶药物进行抗肿瘤治疗时,有必要注意肺大疱破裂的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2582/9302245/9a16c50fdaf7/medi-101-e29273-g001.jpg

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