title: Resolution of vocal fold leukoplakia during erlotinib treatment for lung cancer.
abstract: Treatment of vocal fold leukoplakia is complicated because it is associated with a high rate of recurrence after excision and it has the potential for progression to malignancy. Authors have presented different approaches to management, one of which is directed serial excisional biopsies. Ideally, a topical or systemic agent could be administered to eradicate this troublesome condition. We present the case of a patient with an 8-year history of vocal fold leukoplakia treated with directed serial biopsies who was subsequently diagnosed with non-small-cell lung cancer and treated with erlotinib. He experienced a complete resolution after 2 months of erlotinib therapy for his lung cancer. Immunohistochemistry confirmed that his lesion exhibited a much higher than normal expression of epidermal growth factor receptor (EGFR), which supports the idea that EGFR antagonism may combat EGFR-avid leukoplakia. However, we caution that the clinical observation made herein is an association and should not be misconstrued as a recommendation regarding the safety, efficacy, or economy of using erlotinib for the treatment of vocal fold leukoplakia.
authors.affiliation: Corresponding author: David O. Francis, MD, MS, Department of Otolaryngology, Vanderbilt Voice Center, 1215 21st Ave. S., Suite 7302, Nashville, TN 37232-8783. Email: david.o.francis@vanderbilt.edu From the Department of Otolaryngology, Vanderbilt Voice Center, Vanderbilt University Medical Center, Nashville, Tenn. (Dr. Francis and Dr. Garrett); the Department of Otolaryngology, University of Minnesota Medical School (Dr. Misono); the Department of Otolaryngology, University of Tennessee College of Medicine, Memphis (Dr. Somerville); and the Department of Otolaryngology, Louisiana State University Health Sciences Center, New Orleans (Dr. McWhorter). The case described in this article occurred at the Vanderbilt Voice Center.
authors.forename: David O
authors.initials: DO
authors.lastname: Francis
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
authors.forename: Jessica
authors.initials: J
authors.lastname: Somerville
authors.forename: Andrew
authors.initials: A
authors.lastname: McWhorter
authors.forename: C Gaelyn
authors.initials: CG
authors.lastname: Garrett
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use*; D006801:Humans; D033162:Incidental Findings; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D007971:Leukoplakia / Q000188:drug therapy* / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D014827:Vocal Cords / Q000187:drug effects / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors