High-Dose Corticosteroid Therapy for Erlotinib-Induced Interstitial Lung Disease in Japanese Patient with Advanced Pancreatic Cancer

摘要

Context Erlotinib is aselective epidermal growth factor receptor tyrosine kinase inhibitor used as atarget therapy against non-small lung cancer and advanced pancreatic cancer. Aregimen of erlotinib plus gemcitabine has been proven to prolong overall survivalin the patient with advanced pancreatic cancer. In addition to common adverseeffects, such as diarrhea, mucositis and skin rash (acne form eruptions), acuteinterstitial lung disease (ILD) has been reported as an infrequent butpotentially fatal complication. We here report a case of a Japanese patient witherlotinib-induced ILD in whom high-dose corticosteroid therapy was successful. Case reportA fifty-five-year-old male with cancer of the head of the pancreas withmultiple liver metastases started treatment with gemcitabine plus erlotinib. Onthe 13th day of erlotinib treatment, he had high fever. Chestcomputed tomography (CT) scan showed a diffuse ground-glass like infiltrationof both lungs. He was diagnosed with ILD, and high-dose corticosteroid therapy was started. Twoweeks after the introduction of steroid therapy, the reticular shadow fadedaway on CT. He was successfully treated with corticosteroid forerlotinib-induced acute ILDalthough he died 6 months after the initiation of chemotherapy owing to diseaseprogression.Conclusion we showed a case of a successfully treated Japanese patientof erlotinib-induced ILD. Because erlotinib-induced ILD would frequently occurin Japanese patients, closer attention to ILD should be paid for Japanesepatients than in Western populations. If erlotinib-induced ILD occurs, ahigh-dose corticosteroid therapy would be a useful option of treatment.