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A case analysis of liver injury induced by gefitinib

Published on Feb. 01, 2024Total Views: 731 times Total Downloads: 290 times Download Mobile

Author: XU Pei 1 ZHANG Mi 2 XIONG Xin 3 HUANG Lu 3

Affiliation: 1. Department of Pharmacy, Yichang Central People's Hospital/Institute of Pharmaceutical Preparations, China Three Gorges University, Hubei Province, Yichang 443000, China 2. Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan 430071,China 3. Department of Pharmacy, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077,China

Keywords: Gefitinib Liver injury Adverse drug reaction

DOI: 10.12173/j.issn.1005-0698.202312074

Reference: XU Pei, ZHANG Mi, XIONG Xin, HUANG Lu.A case analysis of liver injury induced by gefitinib[J].Yaowu Liuxingbingxue Zazhi,2024, 33(1):111-115.DOI: 10.12173/j.issn.1005-0698.202312074.[Article in Chinese]

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Abstract

A 68-year-old male patient with malignant left lung tumor was treated with gefitinib (250 mg, po, qd) for 29 days. Liver function test results showed AST 310 U·L-1, ALT 493 U·L-1, AKP 100 U·L-1, TBil 18 µmol·L-1, GGT 60 U·L-1, INR 1.81. Several liver function indicators of the patient showed abnormal, which was consistent with the clinical manifestations of moderate liver injury. The liver function index of the patient improved after the doctor adopted the suggestion of clinical pharmacists to protect the liver. Clinical pharmacists made a comprehensive and dynamic assessment of the patient's condition, analyzed the correlation between the patient's liver injury and gefitinib, and judged that the patient's liver injury was likely caused by gefitinib. Clinical pharmacists analyzed the drug use of a blind trial patient, proposed the follow-up treatment plan, and discussed the blind trial drugs, which provided references for clinical safe and rational drug use and had important reference significance.

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References

1.周昌明, 王泽洲, 郑莹. 2023年美国癌症数据解读及对中国癌症防治的启示[J]. 中国癌症杂志, 2023, 33(2): 117-125. [Zhou CM, Wang ZZ, Zheng Y. Interpretation of cancer data in 2023 in the United States and its implications for cancer prevention and treatment in China[J]. Chinese Journal of Cancer, 2010, 33(2): 117-125.] DOI: 10.19401/j.cnki.1007-3639.2023.02.004.

2.Kazandjian D, Blumenthal GM, Yuan W, et al. FDA approval of gefitinib for the treatment of patients with metastatic EGFR mutation-positive non-small cell lung cancer[J]. Clin Cancer Res, 2016, 22(6): 1307-1312. DOI: 10.1158/1078-0432.ccr-15-2266.

3.Teo YL, Ho HK, Chan A. Risk of tyrosine kinase inhibitors-induced hepatotoxicity in cancer patients: a meta-analysis[J]. Cancer Treat Rev, 2013, 39(2): 199-206. DOI: 10.1016/j.ctrv.2012.09.004.

4.贾东丽, 张阳, 韩欢欢. 吉非替尼致药物性肝损伤1例[J].中南药学,2021, 19(9): 1996-1998. [Jia DL, Zhang Y, Han HH. Drug induced liver injury induced by gefitinib: a case report[J]. Chinese and Southern Pharmacology, 201, 19(9): 1996-1998.] DOI: 10.7539/j.issn.1672-2981.2021. 09.044.

5.中华医学会肝病学分会药物性肝病学组. 《药学物性肝损伤诊治指南(2015年版)》[S]. 2015.

6.Chen J, Gu R, Wang Q, et al.Gefitinib-induced hepatotoxicity in patients treated for non-small cell lung cancer[J].Onkologie, 2012, 35(9): 509-513. DOI: 10.1159/000341828.

7.Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries[J]. J Clin Epidemiol, 1993, 46(11): 1323-1330. DOI: 10.1016/0895-4356(93)90101-6.

8.徐媛, 方忠宏, 冉姗. 1例多因素所致药物性肝损伤病例的病因论证与药学监护[J]. 药物流行病学杂志, 2023, 32(3): 350-355. [Xu Y, Fang ZH, Ran S. etiology and pharmaceutical care of a case of multi-factor drug-induced liver injury[J]. Chin J Pharmacoepidemiol, 2023, 32(3): 350-355.] DOI: 10.19960/j.issn.1005-0698.202303013.

9.Kijima T, Shimizu T, Nonen S, et al. Safe and successful treatment with erlotinib after gefitinib induced hepatotoxicity: difference in metaholism as a possible mechanism[J]. J Clin Oncol, 2011, 29(19): e588-590. DOI: 10.1200/jco.2010.34.3368.

10.Luo P, Yan H, Du J, et al. PLK1 (polo like kinase 1)- dependent autophagy facilitates gefitinib-induced hepatotoxicity by degrading COX6A1 (cytochrome c oxidase subunit 6A1)[J]. Autophagy, 2021, 17(10): 3221-3237. DOI: 10.1080/15548627.2020.1851492.

11.中国抗癌协会肺癌专业委员会. EGFR-TKI不良反应管理专家共识[J]. 中国肺癌杂志, 2019, 22(2): 57-81. DOI: 10.3779/j.issn.1009-3419.2019.02.01.

12.刘华丽, 许斌, 韩光, 等. EGFR-TKI在非小细胞肺癌中的研究进展[J]. 中国肿瘤, 2018, 27(4): 285-293. [Liu HL, Xu B, Han G, et al. Research progress of EGFR-TKI in non-small cell lung cancer[J]. China Cancer, 2018, 27(4): 285-293.] DOI: 10.11735/j.issn.1004-0242. 2018.04.A008.

13.Kitade H, Yamada T, Lgarashi S, et al. Efficacy of low-dose erlotinib against gefitinib-induced hepatotoxicity in a patient with lung adenocarcinoma harboring EGFR mutations[J]. Gan To Kagaku Ryoho, 2013, 40(1): 79-81. https://pubmed.ncbi.nlm.nih.gov/23306923/.

14.Yano Y, Namba Y, Mori M, et al. Treatment of non-small-cell lung cancer with erlotinib following gefitinib-induced hepatotoxicity: review of 8 clinical cases[J]. Lung Cancer Int, 2012, 2012: 354657. DOI: 10.1155/2012/354657.

15.Yuichiro O, Fumio I, Naoyuki N, et al. Osimertinib versus standard-of-care EGFR-TKI as first-line treatment for EGFRm advanced NSCLC: FLAURA Japanese subset[J]. Jpn J Clin Oncol, 2019, 49(1): 29-36. DOI: 10.1093/jjco/hyy179.

16.Cho BC, Chewaskulyong B, Lee KH, et al. Osimertinib versus standard-of-care EGFR-TKI as first-line treatment in patients with EGFRm advanced NSCLC: FLAURA Asian subset[J]. J Thorac Oncol, 2019, 14(1): 99-106. DOI: 10.1016/j.jtho.2018.09.004.

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