达可替尼治疗肺腺癌出现甲横沟和尿酸升高1例

A Case of Nail Transverse Groove and Elevated Uric Acid in Lung Adenocarcinoma Treated with Dacomitinib

目的:报道1例达可替尼治疗肺腺癌后出现甲横沟和尿酸升高。方法:描述1名90岁的肺腺癌晚期患者经基因检测提示EGFR 21号外显子突变,予以达可替尼靶向治疗后出现副反应。结果:达可替尼靶向治疗1月后出现口腔溃疡、腹泻、手指和脚趾开裂并疼痛,复查实验室检查异常的有血红蛋白、淋巴细胞绝对值、白蛋白、钙、癌胚抗原较基线资料下降,尿酸较前升高。双手手指出现甲横沟。结论:密切观察达可替尼治疗肺腺癌的副反应,及时调整治疗方案。

Objective: To report for the first time a case of elevated nail transverse groove and uric acid after dacomitinib treatment for lung adenocarcinoma. Methods: A 90-year-old patient with advanced lung adenocarcinoma with genetic testing suggesting EGFR21 exon mutation developed side effects after targeted treatment with dacomitinib. Results: After 1 month of dacomitinib-targeted therapy, he developed oral ulcers, diarrhea, cracked and painful fingers and toes, and abnormal laboratory tests on review included decreased hemoglobin, absolute lymphocyte values, albumin, calcium, and carcinoembryonic antigen compared with baseline data, and increased uric acid compared with previous data. Transverse nail grooves appeared in the fingers of both hands. Conclusion: The side effects of dacomitinib for lung adenocarcinoma should be closely observed and the treatment regi-men should be adjusted in a timely manner.