title: Successful treatment of non-small-cell lung cancer with afatinib and a glucocorticoid following gefitinib- and erlotinib-induced interstitial lung disease: A case report.
abstract: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)-induced interstitial lung disease (ILD) may be a life-threatening condition that may develop during treatment of lung cancer patients harboring EGFR mutations. We herein present the case of a 41-year-old female patient diagnosed with lung adenocarcinoma with an EGFR mutation (exon 19 deletion). The patient was treated with gefitinib followed by erlotinib and developed ILD induced by both EGFR-TKIs; furthermore, the patient acquired resistance to EGFR-TKI treatment. A repeat biopsy revealed a T790M mutation, which is associated with resistance to first-generation EGFR-TKIs, along with an exon 19 deletion identified by cytology of the pleural fluid. Treatment with afatinib and prednisolone resulted in tumor shrinkage, without worsening of the ILD. The present case demonstrated that combination treatment with afatinib and a glucocorticoid may be effective for the treatment of lung cancer patients who develop EGFR-TKI-induced ILD.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tani
authors.affiliation: Cancer Center, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Naoki
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Asakura
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Masuzawa
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Kuroda
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasuda
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Soejima
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Betsuyaku
keywords: afatinib; erlotinib; gefitinib; interstitial lung disease; non-small-cell lung cancer