Switching of icotinib, erlotinib and gefitinib due to severe adverse effects
Author(s): SI Xiaoyan, WANG Hanping, ZHANG Xiaotong, WANG Mengzhao, ZHANG Li
Pages: 182-185
Year: 2017 Issue: 2
Journal: Oncology Progress
Keyword: lung cancer; epidermal growth factor receptor-tyrosine kinase inhibitor; adverse effect; medication switch;
Abstract: Objective To explore whether it is safe to try another epidermal growth factor receptor-tyrosine kinase in-hibitor (EGFR-TKI) for patients who experienced severe adverse effects during treatment so that they could benefit more from EGFR-TKIs. Method A retrospective review was conducted in medical records of patients who were given EGFR-TKIs. Patients who had switched to another EGFR-TKI due to severe adverse effects were included in the analysis, and the efficacy and safety were analyzed. Related literature were searched in Pubmed, and then were summarized. Result Four patients switched EGFR-TKIs due to severe adverse effects, and all were male, with a median age of 55 (45~78). Se-vere adverse effects included hepatotoxicity in 3 (grade Ⅳ in 2, grade Ⅲ in 1) and dermatologic toxicity in 1 (HSP). 1 had switched from erlotinib to icotinib, 2 from icotinib to erlotinib and 1 from gefitinib to icotinib. No severe adverse ef-fects recurred after any medication change. Thirteen literatures including 54 cases were eligible for analysis. Most pa-tients switched from gefitinib to erlotinib due to hepatotoxicity. Conclusion With careful monitoring, switching of ico-tinib, erlotinib and gefitinib is an alternative strategy for patients who have good response to EGFR-TKI, but more cases should be collected to establish robust evidence, and further researches are needed to clarify the mechanisms.
Pages: 182-185
Year: 2017 Issue: 2
Journal: Oncology Progress
Keyword: lung cancer; epidermal growth factor receptor-tyrosine kinase inhibitor; adverse effect; medication switch;
Abstract: Objective To explore whether it is safe to try another epidermal growth factor receptor-tyrosine kinase in-hibitor (EGFR-TKI) for patients who experienced severe adverse effects during treatment so that they could benefit more from EGFR-TKIs. Method A retrospective review was conducted in medical records of patients who were given EGFR-TKIs. Patients who had switched to another EGFR-TKI due to severe adverse effects were included in the analysis, and the efficacy and safety were analyzed. Related literature were searched in Pubmed, and then were summarized. Result Four patients switched EGFR-TKIs due to severe adverse effects, and all were male, with a median age of 55 (45~78). Se-vere adverse effects included hepatotoxicity in 3 (grade Ⅳ in 2, grade Ⅲ in 1) and dermatologic toxicity in 1 (HSP). 1 had switched from erlotinib to icotinib, 2 from icotinib to erlotinib and 1 from gefitinib to icotinib. No severe adverse ef-fects recurred after any medication change. Thirteen literatures including 54 cases were eligible for analysis. Most pa-tients switched from gefitinib to erlotinib due to hepatotoxicity. Conclusion With careful monitoring, switching of ico-tinib, erlotinib and gefitinib is an alternative strategy for patients who have good response to EGFR-TKI, but more cases should be collected to establish robust evidence, and further researches are needed to clarify the mechanisms.
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