厄洛替尼致间质性肺病4例并文献复习

Four Cases of Interstitial Lung Disease Induced by Erlotinib and A Review of the Literatures

厄洛替尼是一种口服表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine ki-nase inhibitor,EGFR-TKI),广泛应用于晚期非小细胞肺癌的治疗。尽管目前认为这类药物安全性良好,但可诱发严重的间质性肺病(interstitial lung disease,ILD)。文献中对吉非替尼所致ILD的报道较多,而对厄洛替尼所致的ILD报道较少。现报道上海市肺科医院4例厄洛替尼所致ILD,并复习相关文献,以使临床医生提高警惕。监测正在服用厄洛替尼患者的肺部症状、体征,做到及时诊断、尽早治疗对于厄洛替尼所致ILD的预后尤为重要。

Erlotinib is an agent of oral epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors which are used for non-small cell lung cancer. Although this class of agents is considered to be relatively safe, the most serious, but rare, adverse reaction is drug-associated interstitial lung disease （ILD）. ILD induced by gefitinib been often described, but the ILD induced by erlotinib is relatively less well known. We here describle four cases oflLD related to erlotinib and review recent literatures to help physicians earlier alert erlotinib-induced ILD. It is important to carefully monitor pulmonary symptoms in all patients who are receiving erlotinib. Early diagnosis and timely intervention is critical in the treatment of drug-induced ILD.