Korean J Crit Care Med.  2016 Feb;31(1):44-48. 10.4266/kjccm.2016.31.1.44.

Successful Treatment with Empirical Erlotinib in a Patient with Respiratory Failure Caused by Extensive Lung Adenocarcinoma

• Jeong SH
• Um SW
• Lee H
• Jeon K
• Lee KJ
• Suh GY
• Chung MP
• Kim H
• Kwon OJ
• Choi YL

• KMID: 2227612
• DOI: http://doi.org/10.4266/kjccm.2016.31.1.44

Abstract

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.

Keyword

erlotinib; mechanical ventilation; non-small-cell lung cancer; respiratory failure

MeSH Terms

Adenocarcinoma*
Aged
Female
Humans
Intensive Care Units
Lung*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor
Respiration, Artificial
Respiratory Insufficiency*
Ventilators, Mechanical
Erlotinib Hydrochloride
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1. Chest radiograph (A) and computed tomography scans (B, C) revealed a 3-cm primary mass in the right middle lobe with extensive lung-to-lung metastases forming a confluent mass in both lungs.

• 

  Fig. 2. Chest radiograph (A) and computed tomography scans (B, C) revealed a dramatic decrease in the extent of the primary mass and multiple metastatic lesions in both lungs after 3 months of erlotinib treatment.

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  Fig. 3. Chest radiograph (A) and computed tomography scans (B, C) showed an interval decrease in the extent of lung-to-lung metastases in both hemithoraces after 9 months of erlotinib treatment.

• 

  Fig. 4. Chest radiograph (A) and computed tomography scans (B, C) performed after 18 months of treatment showed a slight increase in the extent of the disease.

Reference

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