Published in:
01-01-2017 | Case report
Successful treatment with gefitinib after Stevens–Johnson syndrome associated with afatinib therapy in a patient with adenocarcinoma of the lung
Authors:
Tomoyuki Otsuka, Aya Tanaka, Hiroaki Azukizawa, Shoko Sasaki, Mikako Ishijima, Takanori Matsuki, Akio Osa, Takeshi Nakatani, Muneyoshi Kuroyama, Haruhiko Hirata, Takashi Kijima
Published in:
International Cancer Conference Journal
|
Issue 1/2017
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Abstract
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.