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Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report

Malignant tumors can induce a hypercoagulable state known as Trousseau syndrome that increases the risk for venous thromboembolism including disabling cerebral infarction. Anticoagulant therapy without anticancer treatment is not effective for amelioration of this coagulation abnormality. Most patie...

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Autores principales: Nonagase, Yoshikane, Takeda, Masayuki, Tanaka, Kaoru, Hayashi, Hidetoshi, Iwasa, Tsutomu, Nakagawa, Kazuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047674/
https://www.ncbi.nlm.nih.gov/pubmed/30034636
http://dx.doi.org/10.18632/oncotarget.25687
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author Nonagase, Yoshikane
Takeda, Masayuki
Tanaka, Kaoru
Hayashi, Hidetoshi
Iwasa, Tsutomu
Nakagawa, Kazuhiko
author_facet Nonagase, Yoshikane
Takeda, Masayuki
Tanaka, Kaoru
Hayashi, Hidetoshi
Iwasa, Tsutomu
Nakagawa, Kazuhiko
author_sort Nonagase, Yoshikane
collection PubMed
description Malignant tumors can induce a hypercoagulable state known as Trousseau syndrome that increases the risk for venous thromboembolism including disabling cerebral infarction. Anticoagulant therapy without anticancer treatment is not effective for amelioration of this coagulation abnormality. Most patients with lung cancer positive for activating mutations of the epidermal growth factor receptor (EGFR) are sensitive to EGFR tyrosine kinase inhibitors (TKIs), but the efficacy and safety of EGFR-TKIs in such patients with a poor performance status (PS) due to Trousseau syndrome has been unclear. We here describe a patient with EGFR mutation–positive lung cancer who developed disabling cerebral infarction due to Trousseau syndrome. Administration of the EGFR-TKI gefitinib and anticoagulant therapy resulted in a partial tumor response and recovery from both the coagulation abnormality and the severe neurological symptoms. After the development of resistance to gefitinib, the EGFR-TKI osimertinib was safely administered until disease progression without recurrence of the coagulation abnormality. This case suggests that gefitinib followed by osimertinib may be a safe and effective treatment option for patients with EGFR mutation–positive lung cancer who experience disabling cerebral infarction due to Trousseau syndrome.
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spelling pubmed-60476742018-07-20 Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report Nonagase, Yoshikane Takeda, Masayuki Tanaka, Kaoru Hayashi, Hidetoshi Iwasa, Tsutomu Nakagawa, Kazuhiko Oncotarget Case Report Malignant tumors can induce a hypercoagulable state known as Trousseau syndrome that increases the risk for venous thromboembolism including disabling cerebral infarction. Anticoagulant therapy without anticancer treatment is not effective for amelioration of this coagulation abnormality. Most patients with lung cancer positive for activating mutations of the epidermal growth factor receptor (EGFR) are sensitive to EGFR tyrosine kinase inhibitors (TKIs), but the efficacy and safety of EGFR-TKIs in such patients with a poor performance status (PS) due to Trousseau syndrome has been unclear. We here describe a patient with EGFR mutation–positive lung cancer who developed disabling cerebral infarction due to Trousseau syndrome. Administration of the EGFR-TKI gefitinib and anticoagulant therapy resulted in a partial tumor response and recovery from both the coagulation abnormality and the severe neurological symptoms. After the development of resistance to gefitinib, the EGFR-TKI osimertinib was safely administered until disease progression without recurrence of the coagulation abnormality. This case suggests that gefitinib followed by osimertinib may be a safe and effective treatment option for patients with EGFR mutation–positive lung cancer who experience disabling cerebral infarction due to Trousseau syndrome. Impact Journals LLC 2018-06-29 /pmc/articles/PMC6047674/ /pubmed/30034636 http://dx.doi.org/10.18632/oncotarget.25687 Text en Copyright: © 2018 Nonagase et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (http://creativecommons.org/licenses/by/3.0/) (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Nonagase, Yoshikane
Takeda, Masayuki
Tanaka, Kaoru
Hayashi, Hidetoshi
Iwasa, Tsutomu
Nakagawa, Kazuhiko
Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title_full Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title_fullStr Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title_full_unstemmed Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title_short Treatment of EGFR mutation–positive non–small cell lung cancer complicated by Trousseau syndrome with gefitinib followed by osimertinib: a case report
title_sort treatment of egfr mutation–positive non–small cell lung cancer complicated by trousseau syndrome with gefitinib followed by osimertinib: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047674/
https://www.ncbi.nlm.nih.gov/pubmed/30034636
http://dx.doi.org/10.18632/oncotarget.25687
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