Three Cases of Lung Cancer Treated Safely and Effectively with Erlotinib Following Gefitinib-induced Hepatotoxicity

Abstract

Background. Gefitinib and erlotinib, tyrosine kinase inhibitors (TKI) that target the epidermal growth factor receptor (EGFR), are anti-cancer agents for unresectable non-small cell lung cancer or recurrent lung cancer. There are a few articles that report successful treatment with erlotinib following gefitinib-induced severe hepatotoxicity. Cases. We herein present three patients with non-small cell lung cancer harboring EGFR mutations. These patients were treated with gefitinib therapy and developed grade 3 or higher hepatotoxicity after several weeks. All of the patients were successfully switched to erlotinib, another EGFR-TKI, without hepatotoxicity. Conclusion. When gefitinib causes severe hepatotoxicity, switching to erlotinib is therefore a possible therapeutic option for lung cancer treatment.