title: Acute and fatal diarrhoea after erlotinib plus abdominal palliative hypofractionated radiotherapy in a metastatic non-small cell lung cancer patient: a case report.
abstract: The management of advanced non-small cell lung cancer (NSCLC) has progressed over the last 3 decades due to advances in chemotherapeutic drugs and targeted agents improving survival and quality of life. In particular erlotinib, an orally available human epidermal growth factor receptor (HER1/EGFR) tyrosine kinase inhibitor advancing through clinical trials for the treatment of various human malignancies in a large placebo-controlled phase III study, has shown a significantly better OS vs. placebo suggesting its potential benefits in third line and possibly in second line treatments. The association of erlotinib with ionizing radiation has been recently published showing an enhancing antitumor activity and good tolerance. No information are available on side effects when erlotinib is associated with abdominal hypofractionated radiotherapy although diarrhoea is the most known side effect dose-limiting toxicity when the abdomen is treated. Here we report a fatal acute diarrhoea in a metastatic NSCLC patient taking erlotinib during abdominal hypofractionated radiotherapy for metastatic spinal cord compression (MSCC).
authors.affiliation: Radiation Oncology Unit, S.G. Moscati Hospital, ASL TA/1, Italy. gisilva@tin.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Silvano
authors.forename: Grazia
authors.initials: G
authors.lastname: Lazzari
authors.forename: Monica
authors.initials: M
authors.lastname: Lovecchio
authors.forename: Carmela
authors.initials: C
authors.lastname: Palazzo
mesh_terms: D000208:Acute Disease; D000368:Aged; D001859:Bone Neoplasms / Q000503:physiopathology / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D003967:Diarrhea / Q000209:etiology*; D000069347:Erlotinib Hydrochloride; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D020714:Maximum Tolerated Dose; D059408:Pain Management; D010166:Palliative Care; D011799:Quinazolines / Q000008:administration & dosage* / Q000009:adverse effects*; D011878:Radiotherapy / Q000009:adverse effects*; D012769:Shock; D013117:Spinal Cord Compression
chemical_list: D011799:Quinazolines; D000069347:Erlotinib Hydrochloride