Li W, He X, Liu H, Zhu J, Zhang HM. Successful treatment after toxic epidermal necrolysis induced by AZD-9291 in a patient with non-small cell lung cancer: A case report. World J Clin Cases 2021; 9(29): 8846-8851 [PMID: 34734065 DOI: 10.12998/wjcc.v9.i29.8846]
Corresponding Author of This Article
Hui-Min Zhang, Director, Doctor, Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of TCM, No. 528 Zhangheng Road, Shanghai 201203, China. zhanghm@shutcm.edu.cn
Research Domain of This Article
Allergy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen Li, Xiang He, Jiong Zhu, Hui-Min Zhang, Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China
Hui Liu, Department of Oncology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China
Author contributions: Li W contributed by collecting and assembling data; Li W and He X conceived, designed the research, analyzed and interpreted data; Zhang HM and He X funded the research; Li W and Liu H provided study materials or patients; All authors wrote the paper.
Supported byNational Natural Science Foundation of China, No. 81974570.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Min Zhang, Director, Doctor, Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of TCM, No. 528 Zhangheng Road, Shanghai 201203, China. zhanghm@shutcm.edu.cn
Received: May 12, 2021 Peer-review started: May 12, 2021 First decision: June 15, 2021 Revised: June 18, 2021 Accepted: August 18, 2021 Article in press: August 18, 2021 Published online: October 16, 2021
Abstract
BACKGROUND
Toxic epidermal necrolysis and Stevens-Johnson syndrome are acute life-threatening skin reactions. AZD9291 has been developed as a third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) with activity against T790M mutation.
CASE SUMMARY
Herein we report a 68-year-old woman who developed a large area of skin necrosis and was diagnosed with toxic epidermal necrolysis after AZD-9291 ingestion. To the best of our knowledge, this is the first case reported in patients with EGFR T790M mutation in non-small cell lung cancer (NSCLC). Cabozantinib combined with erlotinib had clinically meaningful effectiveness, with additional toxicity that was generally manageable.
CONCLUSION
Treatment with AZD-9261 is effective in regressing the growth of the NSCLC and can bring some hope to despairing patients. We hope that more research will be carried out on the association between severe rashes and EGFR-TKIs, and more safe and effective drugs can be developed.
Core Tip: To the best of our knowledge, this is the first case reported in a patient with epidermal growth factor receptor T790M mutation in non-small cell lung cancer. Cabozantinib combined with erlotinib had clinically meaningful effectiveness, with additional toxicity that was generally manageable.
