Gefitinib (Iressa®), a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, is effective in patients with advanced non-small cell lung cancer (NSCLC). However, since interstitial lung disease, a fatal adverse event, has occurred more frequently since gefitinib came on to the market, and ISEL and SWOG 0023 examinations have not shown any significant life-extending efficacy, patients have started to feel uneasy about being treated with it. In these circumstances, in the present study, we created a system under which pharmacists can be directly involved in treatment with gefitinib and monitor for adverse events. The subjects were 98 patients with NSCLC who were treated at our hospital, and received gefitinib at a dose of 250 mg once daily. We made a leaflet describing gefitinib and a check sheet for adverse events, and using them, explained the expected adverse events to patients and monitored their conditions. Common drug-related adverse events occurring were rash (54%), pruritus (29%) and diarrhea (23%), and most were graded as mild in degree (grade 1 or 2). Interstitial lung disease was observed in 10 of the 98 patients (10.2%), but none died. Liver injury of grade 3 or 4 occurred in 25 of 92 patients (27.2%), and some patients experienced liver injury one year after the administration of gefitinib. It is therefore necessary to monitor for adverse events in the long-term, especially liver injury. In conclusion, we consider it important for pharmacists to reassure patients about gefitinib and detect the adverse events early.
