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Subacute transient encephalopathy induced by erlotinib
Takako Okyuama1, Yuki Akazawa, Junji Uchida
1Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. okuyama-ta@mc.pref.osaka.jp
Erlotinib (Tarceva), used for non-small cell lung cancer (NSCLC), rarely causes central nervous system (CNS) toxicity. This report details a case of reversible subacute encephalopathy during erlotinib treatment.
Area of Science:
- Oncology
- Neurology
- Pharmacology
Background:
- Erlotinib (Tarceva) is a targeted therapy for non-small cell lung cancer (NSCLC) with EGFR mutations.
- Common side effects include skin rash and diarrhea; severe toxicities are rare.
- Central nervous system (CNS) toxicity is infrequently reported with erlotinib.
Observation:
- A 75-year-old female NSCLC patient developed subacute encephalopathy during erlotinib treatment.
- Symptoms included irritability, loss of consciousness, convulsions, confusion, lethargy, and incontinence.
- Exclusion of other causes via MRI, CSF, and serum analysis was performed.
Findings:
- Subacute encephalopathy was diagnosed in the patient during erlotinib therapy.
- No evidence of brain metastasis, leptomeningeal carcinomatosis, metabolic, hepatic, or infectious causes was found.
- Symptoms resolved spontaneously and rapidly after discontinuing erlotinib.
Implications:
- This case highlights a rare but reversible CNS toxicity associated with erlotinib.
- It underscores the importance of considering drug-induced encephalopathy in NSCLC patients on erlotinib.
- Further investigation into the mechanisms of erlotinib-induced CNS effects may be warranted.
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