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Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity

We report an 80-year-old woman with EGFR-mutant lung adenocarcinoma with multiple brain metastases (BMs). All lesions including BM showed a successful resolution after initiating daily 150 mg erlotinib. However, a grade 2 bilirubin-increase developed, and it was necessary to reduce the dose of erlot...

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Autores principales: Yamanaka, Yumie, Sekine, Akimasa, Kato, Terufumi, Yamakawa, Hideaki, Ikeda, Satoshi, Baba, Tomohisa, Iwasawa, Tae, Okudela, Koji, Ogura, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709634/
https://www.ncbi.nlm.nih.gov/pubmed/28943548
http://dx.doi.org/10.2169/internalmedicine.8638-16
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author Yamanaka, Yumie
Sekine, Akimasa
Kato, Terufumi
Yamakawa, Hideaki
Ikeda, Satoshi
Baba, Tomohisa
Iwasawa, Tae
Okudela, Koji
Ogura, Takashi
author_facet Yamanaka, Yumie
Sekine, Akimasa
Kato, Terufumi
Yamakawa, Hideaki
Ikeda, Satoshi
Baba, Tomohisa
Iwasawa, Tae
Okudela, Koji
Ogura, Takashi
author_sort Yamanaka, Yumie
collection PubMed
description We report an 80-year-old woman with EGFR-mutant lung adenocarcinoma with multiple brain metastases (BMs). All lesions including BM showed a successful resolution after initiating daily 150 mg erlotinib. However, a grade 2 bilirubin-increase developed, and it was necessary to reduce the dose of erlotinib to 50 mg every other day, which aggravated BM. Switching erlotinib to afatinib led to the resolution of BM without an increase in the bilirubin level. Our results indicate that afatinib is an important treatment option when erlotinib-induced hepatotoxicity develops, regardless of the patients' age. Particularly in those patients with BM, switching to afatinib may be preferable to reducing the dose of erlotinib.
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spelling pubmed-57096342017-12-04 Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity Yamanaka, Yumie Sekine, Akimasa Kato, Terufumi Yamakawa, Hideaki Ikeda, Satoshi Baba, Tomohisa Iwasawa, Tae Okudela, Koji Ogura, Takashi Intern Med Case Report We report an 80-year-old woman with EGFR-mutant lung adenocarcinoma with multiple brain metastases (BMs). All lesions including BM showed a successful resolution after initiating daily 150 mg erlotinib. However, a grade 2 bilirubin-increase developed, and it was necessary to reduce the dose of erlotinib to 50 mg every other day, which aggravated BM. Switching erlotinib to afatinib led to the resolution of BM without an increase in the bilirubin level. Our results indicate that afatinib is an important treatment option when erlotinib-induced hepatotoxicity develops, regardless of the patients' age. Particularly in those patients with BM, switching to afatinib may be preferable to reducing the dose of erlotinib. The Japanese Society of Internal Medicine 2017-09-25 2017-11-01 /pmc/articles/PMC5709634/ /pubmed/28943548 http://dx.doi.org/10.2169/internalmedicine.8638-16 Text en Copyright © 2017 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Yamanaka, Yumie
Sekine, Akimasa
Kato, Terufumi
Yamakawa, Hideaki
Ikeda, Satoshi
Baba, Tomohisa
Iwasawa, Tae
Okudela, Koji
Ogura, Takashi
Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title_full Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title_fullStr Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title_full_unstemmed Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title_short Afatinib Therapy for Brain Metastases Aggravated by a Reduction in the Dose of Erlotinib Due to the Development of Hepatotoxicity
title_sort afatinib therapy for brain metastases aggravated by a reduction in the dose of erlotinib due to the development of hepatotoxicity
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709634/
https://www.ncbi.nlm.nih.gov/pubmed/28943548
http://dx.doi.org/10.2169/internalmedicine.8638-16
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