title: Readministration of gefitinib in a responder after treatment discontinuation due to gefinitib-related interstitial lung disease: a case report.
abstract: BACKGROUND
  Gefitinib is a new molecular-targeted agent for the treatment of patients with advanced non-small cell lung cancer that fail to respond to conventional chemotherapy. Gefitinib is considered to be well tolerated and less toxic compared with conventional cytotoxic drugs. However, interstitial lung disease (ILD) has been reported as a serious adverse effect. The precise management of a gefitinib responder having severe adverse events remains unknown.
  
  
  METHODS
  We report the case of gefitinib readministration in a patient with lung adenocarcinoma who had once responded but in whom treatment had to be discontinued owing to gefinitib-related ILD. A dramatic response was achieved both at the time of initial treatment (250 mg/day) and at readministration of gefitinib (125 mg/day). The effectiveness of gefitinib therapy in our patient could be explained in part by the presence of an activating mutation of epidermal growth factor receptor (EGFR) gene, L858R in exon 21, which was identified in the primary tumor.
  
  
  CONCLUSIONS
  A reduced dose of gefitinib might be sufficient for patients having tumors with EGFR gene mutations, and that the currently approved dose may be excessively potent in some of these patients, thus resulting in the onset of adverse events.
authors.affiliation: First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 435-3192 Japan. ktakamoc@hama-med.ac.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takamochi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Suzuki
authors.forename: Abul Hasan Muhammad
authors.initials: AH
authors.lastname: Bashar
authors.forename: Kiyoshige
authors.initials: K
authors.lastname: Yajima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Mochizuki
authors.forename: Toru
authors.initials: T
authors.lastname: Itaya
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Funai