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Gastric perforation related to concurrent use of nintedanib and ramucirumab

Saeko Takahashi1, Saori Murata1, Yudai Yoshino2

  • 1Department of Pulmonary Medicine Tokyo Saiseikai Central Hospital Tokyo Japan.

Respirology Case Reports
|November 21, 2018
PubMed

Insights

Idiopathic pulmonary fibrosis (IPF) patients treated with nintedanib may develop lung cancer. A case report details a patient experiencing gastric perforation after receiving ramucirumab plus docetaxel for non-small cell lung cancer while on nintedanib.

Area of Science:

  • Oncology
  • Pulmonology
  • Pharmacology

Background:

  • Idiopathic pulmonary fibrosis (IPF) affects 9.8–38% of patients with lung cancer.
  • Nintedanib, a tyrosine kinase inhibitor (TKI), is approved for IPF.
  • Ramucirumab plus docetaxel is approved for advanced non-small cell lung cancer (NSCLC).

Observation:

  • A 70-year-old man with IPF was treated with nintedanib.
  • He later developed pulmonary adenocarcinoma and received ramucirumab plus docetaxel as seventh-line therapy.
  • He experienced gastric perforation during his second chemotherapy cycle.

Findings:

  • This case highlights a potential drug interaction between nintedanib and ramucirumab plus docetaxel.
  • The patient developed gastric perforation after concurrent treatment.

Implications:

  • Physicians should be aware of the potential for severe adverse events when treating IPF patients with nintedanib who subsequently require chemotherapy for NSCLC.
  • Further research is needed to understand and manage this drug interaction.
  • This case underscores the importance of vigilant patient monitoring during combination cancer therapies.
Keywords:
Gastrointestinal perforationVEGFnintedanibnon‐small cell lung carcinomaramucirumab

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