Reactions 1680, p130 - 2 Dec 2017 Hepatotoxicity: case report A 80-year-old woman developed hepatotoxicity during treatment with erlotinib [route not stated]. The woman, who had a history of stage IV lung adenocarcinoma, started receiving treatment with erlotinib 150mg daily in December 2015. After four days of initiation of erlotinib, she experienced an increase in total bilirubin level to 2.5 mg/dL. She was deemed to have developed grade 2 hepatotoxicity that was induced by erlotinib. The treatment with erlotinib was temporarily stopped. In January 2016, erlotinib was restarted. In February 2016, the dose was adjusted to 100mg every other day and total bilirubin level was carefully monitored. However, her serum total bilirubin increased to 2.7 mg/dL (peak level) at a dose of 75mg every other day. Hence, the dose was reduced to 50mg every other day. Subsequently, in May 2016, treatment with erlotinib was discontinued and was switched to afatinib. Her underlined condition showed radiological resolution at 1 month after the initiation of afatinib, without further increase in the bilirubin level. Author comment: "Our results indicate that afatinib is an important treatment option when erlotinib-induced hepatotoxicity develops, regardless of the patients’ age." Yamanaka Y, et al. Afatinib therapy for brain metastases aggravated by a reduction in the dose of erlotinib due to the development of hepatotoxicity. Internal Medicine 56: 2895-2898, No. 21, 2017. Available from: URL: http://doi.org/10.2169/ internalmedicine.8638-16 - Japan 803284478 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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