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

Yosuke Togashi, Katsuhiro Masago, Yasuhiro Hamatani, Yuichi Sakamori, Hiroki Nagai, Young Hak Kim, Michiaki Mishima

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

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 with recurrence of ILD. This may suggest that corticosteroids can prevent recurrence due to their antiinflammatory properties.

Original languageEnglish
Pages (from-to)464-468
Number of pages5
JournalLung Cancer
Volume77
Issue number2
DOIs
Publication statusPublished - Aug 2012
Externally publishedYes

Keywords

  • Epidermal growth factor receptor gene mutation
  • Epidermal growth factor receptor tyrosine kinase inhibitor
  • Erlotinib
  • Gefitinib
  • Interstitial lung disease
  • Leptomeningeal metastases
  • Rechallenge

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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