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Gefitinib for non-small cell lung cancer patients with liver cirrhosis

Young Hak Kim1, Tadashi Mio, Michiaki Mishima

  • 1Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. ekim@kuhp.kyoto-u.ac.jp

Internal Medicine (Tokyo, Japan)
|September 17, 2009
PubMed

Insights

Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), shows promise for patients with liver dysfunction. Limited toxicity and similar pharmacokinetics suggest potential for reduced dosing in this population.

Area of Science:

  • Oncology
  • Pharmacology
  • Hepatology

Background:

  • Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) like gefitinib are primarily metabolized by the liver.
  • Limited safety data exists for administering EGFR-TKIs to patients with liver dysfunction.
  • Adenocarcinoma patients with liver cirrhosis present a challenge for EGFR-TKI therapy.

Observation:

  • Gefitinib was administered to two adenocarcinoma patients with liver cirrhosis.
  • One patient with an EGFR gene mutation in exon 21 experienced long-term stable disease (SD) without toxicity.
  • Pharmacokinetic data from alternate-day gefitinib administration in these patients resembled daily administration in patients with normal liver function.

Findings:

  • Gefitinib demonstrated a favorable safety profile in a small cohort of patients with liver cirrhosis.
  • Pharmacokinetics suggest that alternate-day dosing may maintain therapeutic levels.
  • Stable disease was achieved in a patient with a specific EGFR mutation.

Implications:

  • Reduced gefitinib dosing may be a feasible strategy for patients with liver dysfunction.
  • Further research is warranted to confirm the safety and efficacy of modified dosing regimens.
  • This study opens avenues for managing EGFR-TKI therapy in patients with compromised liver function.

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