title: Erlotinib is a well-tolerated alternate treatment for non-small cell lung cancer in cases of gefitinib-induced hepatotoxicity.
abstract: OBJECTIVE
  To evaluate the tolerability and efficacy of erlotinib treatment in advanced non-small cell lung cancer (NSCLC) patients who had previously experienced severe hepatotoxicity after gefitinib treatment.
  
  
  METHODS
  Twenty-five NSCLC patients with epidermal growth factor receptor (EGFR) mutation were initially treated with gefitinib (250 mg/day). However, 7 of these experienced severe hepatotoxicity. After recovery from hepatotoxicity, treatment was switched to erlotinib (150 mg/day) in all 7 patients. Toxicity and efficacy of erlotinib were analyzed.
  
  
  RESULTS
  None of the 7 patients reported severe hepatotoxicity with erlotinib despite gefitinib-induced severe hepatotoxicity. All patients achieved response with gefitinib or following erlotinib treatment. The response achieved with gefitinib was maintained after switching to erlotinib. Therefore, an excellent median progression-free survival of 372 days was achieved although gefitinib induced severe hepatotoxicity.
  
  
  CONCLUSIONS
  Erlotinib treatment was efficient and well-tolerated in NSCLC patients with EGFR mutation, despite their severe hepatotoxicity with prior gefitinib treatment.
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan yonesaka2002@yahoo.co.jp.
authors.forename: Kimio
authors.initials: K
authors.lastname: Yonesaka
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Suzumura
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsukuda
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ozaki
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Takamune
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Izumi Municipal Hospital, Department of Medical Oncology, Izumi, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D056486:Chemical and Drug Induced Liver Injury; D057915:Drug Substitution; D000069347:Erlotinib Hydrochloride; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib
keywords: EGFR; Non-small cell lung cancer; chemotherapy; erlotinib; gefitinib; hepatotoxicity