Tuberc Respir Dis.  2011 Oct;71(4):286-290.

Successful Rechallenge with Gefitinib for an Initial Erlotinib-Responder with Advanced Lung Adenocarcinoma

  • 1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.


Although failure of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) is generally believed to be associated with cross-resistance to other EGFR TKI, the benefit of administering erlotinib as a second EGFR TKI after resistance of gefitinib as the first TKI has been well known. However, good response to gefitinib after an initial response to erlotinib has been rare. We report that a 45-year-old woman (never smoked), with lung adenocarcinoma and EGFR mutation, showed an initial response to erlotinib, and then responded to gefitinib again.


erlotinib; gefitinib; Adenocarcinoma of lung

MeSH Terms

Lung Neoplasms
Middle Aged
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor
Erlotinib Hydrochloride
Lung Neoplasms
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor


  • Figure 1 (A) A chest radiograph showed multiple nodules in both lungs. (B) Computed tomography of chest showed a primary mass (an arrow) in right lower lobe with multiple nodules in both lungs (Jun-2007). (C) The EGFR sequencing disclosed a deletion in exon 19 (del.nt 2235-2249). EGFR: epidermal growth factor receptor.

  • Figure 2 Computed tomography of chest shows (A) a mass in right lower lobe (an arrow) and multiple nodules (May-2008). (B) After erlotinib treatment, the mass was markedly reduced and cavity formation was seen (an arrow, Sep-2008) and (C) multiple tiny nodule in both lungs were noted (Sep- 2008). (D) A metastatic nodule had newly appeared in left lower lobe (an arrow head, May-2009).

  • Figure 3 (A) Chest radiograph and (C) computed tomography (CT) of chest in Apr 2010 showed that a mass [an arrow (A) and an arrowhead (C)] in right lower lobes. (B) Chest radiograph and (D) CT of chest in Jul 2010 showed that the mass [an arrow (B) and an arrowhead (D)] was decreased after gefitinib treatment.

  • Figure 4 Time course of anti-cancer treatment, carcinoembryonic antigen level (diamonds), and radiologic finding since initial diagnosis of lung adenocarcinoma. *Vinorelbine+cisplatin; F: figure.


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