Successful erlotinib rechallenge for leptomeningeal metastases of lung adenocarcinoma after erlotinib-induced interstitial lung disease: a case report and review of the literature

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Yosuke TogashiMichiaki Mishima

Abstract

The most serious adverse reaction associated with treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is drug-induced interstitial lung disease (ILD). Because EGFR-TKIs are key drugs for patients with non-small cell lung cancer who have somatic activating mutations of the epidermal growth factor receptor gene (EGFR mutations), several cases of retreatment with EGFR-TKIs after ILD induced by these drugs have been reported. Here, we present a 68-year-old man with lung adenocarcinoma and leptomeningeal metastases having an EGFR mutation who was retreated with erlotinib after erlotinib-induced ILD. He suffered no ILD recurrence and his leptomeningeal metastases dramatically improved. In addition to the present case, reports of nine patients who were retreated with EGFR-TKIs after ILD were found in the literature. Only one patient had recurrence of ILD (although seven were retreated at a reduced dose of EGFR-TKIs, including the patient with recurrence). In contrast, three patients had no recurrence of ILD even without dose-reduction. These reports suggest that dose-reduction plays a limited role in preventing recurrence. Many patients received corticosteroids during retreatment, but not the one wit...Continue Reading

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Citations

May 30, 2014·Japanese Journal of Clinical Oncology·Motoko TachiharaYoshihiro Nishimura
Aug 22, 2015·Expert Opinion on Drug Metabolism & Toxicology·Laure-Anne TeuwenLuc Dirix
Jul 17, 2013·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Satoru YanagisawaMasakazu Ichinose
Aug 19, 2016·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Rashmi R Shah
May 30, 2013·Surgical Neurology International·Emilie Le RhunMarc C Chamberlain
Feb 3, 2015·Therapeutic Advances in Drug Safety·Gordon Mallarkey, Arduino A Mangoni
Jun 29, 2021·Therapeutic Advances in Medical Oncology·Christiane BickertAmanda Tufman

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