Li Xiaoqing, Ma Suhua, She Qing, Liu Zirong, Liu Yanan, Kuang Yanjing, Huang Xiaozhun, Zhan Zhengyin
Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Front Oncol. 2025 Mar 25;15:1505596. doi: 10.3389/fonc.2025.1505596. eCollection 2025.
Adjuvant lenvatinib in combination with transarterial chemoembolization (TACE) has demonstrated prolonged disease-free survival in hepatocellular carcinoma patients at high risk of recurrence post-resection. Here, we present the case of a 68-year-old woman who developed serious side effects including pemphigus erythematosus (PE) linked to lenvatinib usage. Initially treated for breast cancer with radical surgery in April 2018 followed by adjuvant therapy, she was later diagnosed with liver cancer, initially mistaken for metastatic breast cancer to the liver. Although systemic treatment for advanced breast cancer was received, the tumor continued to progress and required partial removal of the liver after final evaluation. Subsequent pathology revealed hepatocellular carcinoma combined with risk factors for recurrence, prompting adjuvant therapy with TACE and oral lenvatinib. After three weeks of lenvatinib administration, the patient developed a skin rash diagnosed as PE through skin pathology. Treatment involved oral methylprednisolone, intravenous human immune globulin, and supportive care, resulting in a cure within a month. This unique case highlights the importance of further research not only on lenvatinib but also on monitoring and managing adverse reactions associated with targeted drugs to optimize patient safety and treatment outcomes.
辅助性乐伐替尼联合经动脉化疗栓塞术（TACE）已证明可延长肝癌切除术后高复发风险患者的无病生存期。在此，我们报告一例68岁女性患者，其出现了与乐伐替尼使用相关的严重副作用，包括红斑性天疱疮（PE）。该患者于2018年4月接受乳腺癌根治术及辅助治疗，随后被诊断为肝癌，最初被误诊为乳腺癌肝转移。尽管接受了晚期乳腺癌的全身治疗，但肿瘤仍持续进展，最终评估后需行肝脏部分切除术。后续病理显示为肝细胞癌合并复发危险因素，遂采用TACE及口服乐伐替尼进行辅助治疗。乐伐替尼给药三周后，患者出现皮疹，经皮肤病理诊断为PE。治疗包括口服甲泼尼龙、静脉注射人免疫球蛋白及支持治疗，一个月内治愈。这一独特病例凸显了不仅要进一步研究乐伐替尼，还要研究监测和管理与靶向药物相关不良反应的重要性，以优化患者安全性和治疗效果。
