title: An autopsy case of bronchiolitis obliterans as a previously unrecognized adverse event of afatinib treatment.
abstract: Interstitial lung disease is a well-known pulmonary adverse event that occurs during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy and results in restrictive ventilatory dysfunction. However, obstructive changes such as those associated with bronchiolitis obliterans (BO) have never been reported as adverse events resulting from the use of any approved EGFR-TKI. This report documents an autopsy case of BO that developed during afatinib treatment for adenocarcinoma of the lung. Knowledge of the possibility of this fatal adverse event is important for adequate follow-up of patients with lung cancer undergoing afatinib treatment.
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: kanaji@med.kagawa-u.ac.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanaji
authors.affiliation: Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: ychiba@med.kagawa-u.ac.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Chiba
authors.affiliation: Division of Pathology, Takamatsu Heiwa Hospital, 1-4-1 Ritsurin-cho, Takamatsu-shi, Kagawa 760-8530, Japan. Electronic address: satoh@kagawa.coop.
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: masaueno@med.kagawa-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: tadokoro@med.kagawa-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Tadokoro
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: kitan0@med.kagawa-u.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kita
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: tishii@med.kagawa-u.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: naoki-w@med.kagawa-u.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: kado@med.kagawa-u.ac.jp.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Kadowaki
authors.affiliation: Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: sbandoh@med.kagawa-u.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Bandoh
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000077716:Afatinib; D001344:Autopsy; D001989:Bronchiolitis Obliterans / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D011799:Quinazolines; D000077716:Afatinib
keywords: Afatinib; Bronchiolitis obliterans; Epidermal growth factor receptor; Obstructive; Tyrosine kinase inhibitor