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Drug-induced liver injury associated with dacomitinib: A case report

Xuanxuan Wang1, Anqi Huang1, Yun Lu1

  • 1Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China.

Frontiers in Oncology
|October 3, 2022
PubMed

Insights

Dacomitinib, an EGFR-TKI for non-small cell lung cancer, can cause drug-induced liver injury (DILI). This case highlights the potential for dacomitinib monotherapy to lead to acute liver failure, necessitating careful monitoring.

Area of Science:

  • Oncology
  • Hepatology
  • Pharmacology

Background:

  • Dacomitinib is a second-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used for EGFR-mutated non-small cell lung cancer (NSCLC).
  • Drug-induced liver injury (DILI) is a potential adverse effect of various medications, including targeted cancer therapies.

Observation:

  • A 59-year-old male with stage IV NSCLC developed jaundice 37 days after initiating dacomitinib.
  • Laboratory tests showed elevated liver enzymes and bilirubin, indicative of liver damage.
  • Despite dacomitinib discontinuation, bilirubin levels peaked at 18-fold the normal range before gradual normalization over 146 days.

Findings:

  • The patient was diagnosed with probable dacomitinib-induced liver injury (DILI) with a severity assessment of acute liver failure.
  • This represents the first reported case of DILI specifically attributed to dacomitinib monotherapy in a clinical setting.
  • Causality was established using the Roussel Uclaf Causality Assessment Method.

Implications:

  • Clinicians must be vigilant for DILI in patients treated with dacomitinib.
  • Early recognition and discontinuation of dacomitinib may be crucial for managing dacomitinib-induced hepatotoxicity.
  • This case underscores the importance of monitoring liver function during EGFR-TKI therapy.
Keywords:
Roussel Uclaf Causality Assessment Methodcase reportdacomitinibdrug-induced liver injurynon-small cell lung cancer

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