title: Successful empirical erlotinib treatment of a mechanically ventilated patient newly diagnosed with metastatic lung adenocarcinoma.
abstract: BACKGROUND
  Lung cancer is the most common solid tumor in critically ill cancer patients who are admitted to intensive care units (ICUs). An ICU trial consists of unlimited ICU support for a limited time period.
  
  
  METHODS
  We present the case of a 60-year-old woman with newly diagnosed metastatic lung adenocarcinoma who required mechanical ventilation due to respiratory failure. Empirical erlotinib treatment was administered through a nasogastric feeding tube as part of an ICU trial, which led to a dramatic and durable response.
  
  
  CONCLUSIONS
  Empirical erlotinib should be considered when epidermal growth factor receptor (EGFR) mutations are suspected in ICU newly diagnosed patients with lung adenocarcinoma.
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain; Girona Biomedical Research Institute (IDIBGi), Girona, Catalonia, Spain; Department of Medical Sciences, Medical School, University of Girona, Girona, Spain. Electronic address: jbosch@iconcologia.net.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bosch-Barrera
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain.
authors.forename: Elia
authors.initials: E
authors.lastname: Sais
authors.affiliation: Intensive Care Unit, Doctor Josep Trueta University Hospital, Girona, Spain.
authors.forename: Carol
authors.initials: C
authors.lastname: Lorencio
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain; Girona Biomedical Research Institute (IDIBGi), Girona, Catalonia, Spain; Department of Medical Sciences, Medical School, University of Girona, Girona, Spain.
authors.forename: Rut
authors.initials: R
authors.lastname: Porta
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain; Girona Biomedical Research Institute (IDIBGi), Girona, Catalonia, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Izquierdo
authors.affiliation: Girona Biomedical Research Institute (IDIBGi), Girona, Catalonia, Spain; Translational Research Laboratory, Catalan Institute of Oncology, Girona, Catalonia, Spain.
authors.forename: Javier A
authors.initials: JA
authors.lastname: Menéndez
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain; Girona Biomedical Research Institute (IDIBGi), Girona, Catalonia, Spain; Department of Medical Sciences, Medical School, University of Girona, Girona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Brunet
authors.affiliation: Intensive Care Unit, Doctor Josep Trueta University Hospital, Girona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Sirvent
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain. Electronic address: rrosell@iconcologia.net.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosell
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride
keywords: Critically ill patient; EGFR mutation; Erlotinib; Intensive care unit; Mechanical ventilation; Nasogastric tube; Non-small-cell lung cancer