Successful treatment with gefitinib after Stevens–Johnson syndrome associated with afatinib therapy in a patient with adenocarcinoma of the lung

We report a case of a 65-year-old woman with stage IV lung adenocarcinoma who experienced Stevens–Johnson syndrome (SJS) during afatinib therapy. The patient received afatinib as the first-line therapy after the confirmation of harboring an exon 19 deletion mutation in the epidermal growth factor re...

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Bibliographic Details
Published inInternational cancer conference journal Vol. 6; no. 1; pp. 38 - 41
Main Authors Otsuka, Tomoyuki, Tanaka, Aya, Azukizawa, Hiroaki, Sasaki, Shoko, Ishijima, Mikako, Matsuki, Takanori, Osa, Akio, Nakatani, Takeshi, Kuroyama, Muneyoshi, Hirata, Haruhiko, Kijima, Takashi
Format Journal Article
LanguageEnglish
Published Tokyo Springer Japan 01.01.2017
Springer Nature B.V
Subjects
Acne
Adenocarcinoma
Bacterial infections
Biopsy
Cancer therapies
Carboplatin
Case Report
Case reports
Conflicts of interest
Drug dosages
Epidermal growth factor
Epidermal growth factor receptors
Erythema
Gefitinib
Gene deletion
Immunoglobulins
Kinases
Lung cancer
Lung diseases
Medicine
Medicine & Public Health
Mutation
Oncology
Patients
Steroids
Surgical Oncology
Non-small-cell lung cancer
EGFR-TKI
Stevens–Johnson syndrome
Afatinib
Gefitinib
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Summary:We report a case of a 65-year-old woman with stage IV lung adenocarcinoma who experienced Stevens–Johnson syndrome (SJS) during afatinib therapy. The patient received afatinib as the first-line therapy after the confirmation of harboring an exon 19 deletion mutation in the epidermal growth factor receptor (EGFR) gene. The patient presented with multiple erythematous papules mainly on the body trunk and thigh 32 days after afatinib administration. Subsequently, diffuse erosions of oral mucosa and purpuric macules with flat atypical targets emerged. Skin biopsy specimen showed the histology compatible with epidermal necrosis and the patient was diagnosed as having SJS. The symptoms of SJS were recovered by systemic steroid and immunoglobulin treatment. Gefitinib was administered as the third-line therapy after the second-line therapy with carboplatin plus pemetrexed had failed. Tumor shrinkage was obtained shortly and has been maintained without the recurrence of SJS. Rechallenge of tyrosine kinase inhibitor by gefitinib could be an alternative treatment option in patients who experienced SJS by afatinib.
ISSN:2192-3183
2192-3183
DOI:10.1007/s13691-016-0269-3