title: Safe and successful treatment with afatinib in three postoperative non-small cell lung cancer patients with recurrences following gefitinib/erlotinib-induced hepatotoxicity.
abstract: BACKGROUND
  Gefitinib and/or erlotinib-induced hepatotoxicity sometimes lead to treatment failure in EGFR mutation-positive patients with non-small cell lung cancer (NSCLC), even though the therapeutic effect is evident.
  
  
  METHODS
  Here, we report three postoperative NSCLC patients with recurrences who experienced severe hepatotoxicity while receiving gefitinib and/or erlotinib treatment but could be safely switched to afatinib treatment.
  
  
  CONCLUSIONS
  Afatinib could be a well-tolerated EGFR-TKI that could be chosen for its relatively low hepatotoxicity, which is attributable to its having a different metabolic mechanism compared to other EGFR-TKIs.
authors.affiliation: Department of Thoracic and Endocrine Surgery and Oncology, Institute of Health Biosciences, University of Tokushima Graduate School.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Toba
authors.forename: Shoji
authors.initials: S
authors.lastname: Sakiyama
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takizawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tangoku
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics; D000077192:Adenocarcinoma of Lung; D000077716:Afatinib; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics; D000069347:Erlotinib Hydrochloride / Q000009:adverse effects; D005260:Female; D000077156:Gefitinib; D018773:Genes, erbB-1; D006801:Humans; D008099:Liver / Q000187:drug effects; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib