Case Report: Afatinib-Induced Interstitial Pneumonia: Experiences and Lessons From Two Patients.
Case Report: Afatinib-Induced Interstitial Pneumonia: Experiences and Lessons From Two Patients.
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病例报告：阿法替尼引起的间质性肺炎：两名患者的经验和教训
DOI：
10.3389/fphar.2021.698447
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发表时间：
2021
影响因子：
5.6
通讯作者：
Zhao L
中科院分区：
文献类型：
--
作者：
Liu X;Ma B;Li T;Zhao L
背景资料：阿法替尼在携带罕见EGFR突变的患者中显示出良好的疗效，但由于其进展迅速，应警惕阿法替尼诱导的间质性肺炎的发生率。在此，我们报告了2例阿法替尼治疗期间发生间质性肺炎的病例。病例介绍：第1例病例是一例58岁男性晚期肺腺癌（cT 4 bN 3 M1 b），携带外显子18 G719 X和外显子20 S781 I EGFR突变，接受阿法替尼治疗。治疗68天后，他出现呼吸急促和发热。未及时诊断药物性肺炎，患者接受经验性抗生素和小剂量糖皮质激素治疗。肺部炎症迅速进展，患者在症状发作后15天死亡。第2例病例为一例57岁男性IV期（cT 3 N3 M1 b）肺腺癌伴21号外显子L 861 Q EGFR突变。他接受阿法替尼作为二线治疗。阿法替尼治疗后22天发生发热和呼吸急促，患者接受经验性抗生素治疗。五天后，CT显示肺部炎症加重，诊断为阿法替尼诱导的间质性肺炎。他接受了糖皮质激素治疗，肺炎很快好转。结论：尽管EGFR-TKI相关性肺炎的发生率并不常见，但在治疗期间必须高度警惕药物诱导的间质性肺炎。早期诊断和早期糖皮质激素治疗可逆转肺损伤。
Background: Afatinib has shown good efficacy in patients harboring uncommon EGFR mutations, but the incidence of afatinib-induced interstitial pneumonia should be alert as its rapid progression. Here, we report two cases of interstitial pneumonia during afatinib treatment. Case presentation: The first case was of a 58-year-old male with advanced lung adenocarcinoma (cT4bN3M1b) with exon 18 G719X and exon 20 S781I EGFR mutations and received afatinib therapy. After 68 days of therapy, he developed shortness of breath and fever. Drug-induced pneumonia was not diagnosed timely, the patient received empirical antibiotics and low-dose glucocorticoids. The pulmonary inflammation rapidly progressed and the patient died 15 days after symptom onset. The second case was of a 57-year-old man with stage IV (cT3N3M1b) lung adenocarcinoma with exon 21 L861Q EGFR mutation. He received afatinib as second-line therapy. Fever and shortness of breath occurred 22 days after afatinib therapy, he received empirical antibiotic therapy. Five days later, CT showed aggravated pulmonary inflammation, and afatinib-induced interstitial pneumonia was diagnosed. He received glucocorticoid therapy, and the pneumonia quickly improved. Conclusion: Although the incidence of EGFR-TKI-associated pneumonia is uncommon, high vigilance for drug-induced interstitial pneumonia is necessary during treatment. Early diagnosis and early glucocorticoid therapy could reverse lung injury.
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影响因子：
4
作者：
Lu, Shun;Li, Wei;Zhang, Li
通讯作者：
Zhang, Li
DOI：
10.1124/jpet.112.197756
发表时间：
2012-11-01
影响因子：
3.5
作者：
Solca, Flavio;Dahl, Goeran;Adolf, Guenther R.
通讯作者：
Adolf, Guenther R.
影响因子：
4
作者：
Wu, Yi-Long;Xu, Chong-Rui;Zhou, Caicun
通讯作者：
Zhou, Caicun
影响因子：
20.4
作者：
Yang, James Chih-Hsin;Schuler, Martin;Kim, Edward S.
通讯作者：
Kim, Edward S.
影响因子：
8.8
作者：
通讯作者：
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