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Journal of Medical Case Reports

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Open Access 01-12-2011 | Case report

Treatment with gefitinib after erlotinib-induced liver injury: a case report

Authors: Katsumi Nakatomi, Yoichi Nakamura, Iida Tetsuya, Shigeru Kohno

Published in: Journal of Medical Case Reports | Issue 1/2011

Abstract

Introduction

Gefitinib and erlotinib have minor differences in their chemical structures, and thus it remains unclear whether the hepatotoxicity induced by one compound is affected by the other. The case of a patient who developed erlotinib-induced liver injury and was then treated with gefitinib without hepatic toxicity or disease progression is presented.

Case presentation

A 31-year-old Japanese woman, who never smoked and who was diagnosed as having lung adenocarcinoma with carcinomatous meningitis, was treated with erlotinib. She developed erlotinib-induced liver injury after four weeks of treatment. The treatment was stopped right away, but the symptoms of meningitis re-appeared immediately. Gefitinib treatment was started and continued without recurrence of drug-induced liver injury.

Conclusion

Gefitinib appears to be a potential treatment option after erlotinib-induced liver injury.

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Siegel-Lakhai WS, Beijnen JH, Schellens JH: Current knowledge and future directions of the selective epidermal growth factor receptor inhibitors erlotinib (Tarceva) and gefitinib (Iressa). Oncologist. 2005, 10: 579-589. 10.1634/theoncologist.10-8-579.CrossRefPubMed

Cascone T, Morelli MP, Ciardiello F: Small molecule epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer. Ann Oncol. 2006, 17 (Suppl 2): ii46-48. 10.1093/annonc/mdj921.CrossRefPubMed

Inoue Y, Fukuoka , Kudoh S, Ando M, Ohe Y, Nakagawa K, Arakawa H, Ebina M, Kiyohara Y, Kusumoto M, Kuwano K, Gemma Y, Sakai F, Johkoh T, Taniguchi H, Fukuda Y, Yamasaki N, Takemoto S, Akiyama : Tarceva Tablet Non-small Cell Lung Cancer Special Drug Use-results Survey Final Analysis about Targeted Numbers (3000 pts) [abstract]. Proc Japan Lung Cancer Society. 2010, 50: O-184-in Japanese

Yoshida S: The results of gefitinib prospective investigation. Med Drug J. 2005, 41: 772-789. in Japanese

Ling J, Johnson KA, Miao Z, Rakhit A, Pantze MP, Hamilton M, Lum BL, Prakash C: Metabolism and excretion of erlotinib, a small molecule inhibitor of epidermalgrowth factor receptor tyrosine kinase, in healthy male volunteers. Drug Metab Dispos. 2006, 34: 420-426.PubMed

McKillop D, McCormick AD, Millar A, Miles GS, Phillips PJ, Hutchison M: Cytochrome P450-dependent metabolism of gefitinib. Xenobiotica. 2005, 35: 39-50. 10.1080/00498250400026464.CrossRefPubMed

Papay JI, Clines D, Rafi R, Yuen N, Britt SD, Walsh JS, Hunt CM: Drug-induced liver injury following positive drug rechallenge. Regul Toxicol Pharmacol. 2009, 54: 84-90. 10.1016/j.yrtph.2009.03.003.CrossRefPubMed

Drug-Induced Liver Injury: Premarketing Clinical Evaluation. FDA Draft Concept Paper. 2007,http://www.fda.gov/cder/guidance/7507dft.html

Takeda M, Okamoto I, Fukuoka M, Nakagawa K: Successful treatment with erlotinib after gefitinib-related severe hepatotoxicity. J Clin Oncol. 2010, 28: e273-274. 10.1200/JCO.2009.26.5496.CrossRefPubMed

10.

Ku GY, Chopra A, Lopes Gde L: Successful treatment of two lung cancer patients with erlotinib following gefitinib-induced hepatotoxicity. Lung Cancer. 2010, 70: 223-225. 10.1016/j.lungcan.2010.08.012.CrossRefPubMed

11.

Li J, Zhao M, He P, Hidalgo M, Baker SD: Differential metabolism of gefitinib and erlotinib by human cytochrome P450 enzymes. Clin Cancer Res. 2007, 13: 3731-3737. 10.1158/1078-0432.CCR-07-0088.CrossRefPubMed

Title: Treatment with gefitinib after erlotinib-induced liver injury: a case report
Authors: Katsumi Nakatomi
Yoichi Nakamura
Iida Tetsuya
Shigeru Kohno
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-5-593

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Treatment with gefitinib after erlotinib-induced liver injury: a case report

Abstract

Introduction

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

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