Afatinib-associated Stevens-Johnson syndrome in an EGFR-mutated lung cancer patient

Lung Cancer. 2016 May:95:35-8. doi: 10.1016/j.lungcan.2016.02.015. Epub 2016 Mar 2.

Abstract

Introduction: Afatinib is a tyrosine kinase inhibitor (TKI), that has been approved for treating patients with epidermal growth factor receptor (EGFR) mutated advanced non-small-cell lung cancer (NSCLC). Stevens-Johnson syndrome (SJS) related to EGFR directed TKIs is a rare adverse event.

Case presentation: We report a case of a 79-year-old white female with EGFR-mutated, metastatic non-small-cell lung cancer treated with afatinib as first-line palliative treatment, who developed a SJS after two months of treatment. Discontinuation of the TKI and systemic glucocorticoid treatment led to improvement of symptoms and recovery.

Conclusion: Severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes during treatment with afatinib should alert clinicians to suspect SJS and react appropriately.

Keywords: Afatinib; NSCLC; SJS; TKI.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Afatinib
  • Aged
  • ErbB Receptors / genetics*
  • Female
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / genetics*
  • Mutation*
  • Protein Kinase Inhibitors / adverse effects*
  • Quinazolines / adverse effects*
  • Skin / pathology
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / drug therapy
  • Stevens-Johnson Syndrome / etiology*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Protein Kinase Inhibitors
  • Quinazolines
  • Afatinib
  • ErbB Receptors