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Facial rash and pustular face rash : case report A 70-year-old man developed facial rash during treatment with gefitinib and developed pustular face rash during treatment with erlotinib for metastatic non-small-cell lung cancer (NSCLC) [routes not stated]. The man was diagnosed with NSCLC (T3N1M1a, clinical stage IV) with pleural effusion and metastasis in the right adrenal gland in September 2014. In November 2014, he was started on first-line therapy with gefitinib 250 mg/day. However, the treatment was complicated by low severity facial rash. On check-up 6 months after the initiation of gefitinib, disease progression was observed. Hence, in May 2015, he was started on second-line therapy with IV carboplatin 425mg (AUC5), IV bevacizumab 7.5 mg/kg of body weight (600mg) and IV paclitaxel 175 mg/m2 (330mg). His performance status remained 0. After 4 cycles of second-line therapy, progression of pleural effusion, lymph nodes and tumour infiltration was observed with treatment failure. The presence of the resistant T790M mutation was not observed. Hence, in Spetember 2015, he was started on erlotinib 150 mg/day. However, he developed grade III pustular face rash as a side effect. Hence, the man’s erlotinib dose was reduced to 100 mg/day. After 5 months, his rash was of grade I. After 1 year treatment with erlotinib, he was free of rash with no other adverse effects. Continuous check-up showed lasting effect of erlotinib with stable disease. In September 2019 (after 4 years of erlotinib treatment), he remained in good condition and tolerated the treatment [time to reactions onsets not stated; not all outcomes stated]. Stastna N, et al. Long-term effect of erlotinib therapy in the third line of anticancer treatment in a patient with non-small-cell lung cancer - a case report. [Czech]. Klinicka 803497260 Onkologie 33: 226-229, No. 3, Jan 2020. Available from: URL: http://doi.org/10.14735/amko2020226 [Czech; summarised from a translation]

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Reactions 22 Aug 2020 No. 1818