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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

Oncology Research
|February 15, 2012
PubMed

Insights

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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