Side Effects of erlotinib: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Main research findings

Erlotinib is an EGFR inhibitor used to treat non-small cell lung cancer. While erlotinib has the effect of inhibiting the growth of tumor cells, it can also cause various side effects. 6 is a case report of subacute cutaneous lupus erythematosus-like eruption caused by erlotinib. 3 suggests that the cause of diarrhea caused by erlotinib may be an increase in calcium-activated chloride secretion and impaired barrier function in intestinal cells. Furthermore, 9 reports a case of cardiomyopathy caused by erlotinib. 17 investigated a new drug that was found to be safer than erlotinib.

Reasons for side effects

Erlotinib is an EGFR inhibitor and is more likely to affect tissues that express EGFR highly, such as skin and heart, which can lead to side effects. 6 believes that the cause of skin side effects from erlotinib is due to inhibition of EGFR in normal skin cells. On the other hand, 3 suggests that the cause of diarrhea caused by erlotinib may be an increase in calcium-activated chloride secretion and impaired barrier function in intestinal cells.

Common side effects

Skin

Skin side effects are common with erlotinib. Specifically, 6 reports subacute cutaneous lupus erythematosus-like eruption, 4 reports acneiform rash, dryness, paronychia, 18 reports palmoplantar keratoderma, and various skin symptoms have been reported. Also, 11 reports a case report of 5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) being effective for acneiform rash caused by erlotinib.

Gastrointestinal

Gastrointestinal side effects of erlotinib include diarrhea, as reported in 3 . Also, 8 reports intestinal obstruction, hypokalemia, and hyponatremia as gastrointestinal side effects of erlotinib.

Heart

Cardiomyopathy has been reported as a cardiac side effect of erlotinib in 9 .

Eye

Eye side effects of erlotinib include excessive eyelash growth, conjunctivitis, as reported in 12 . Also, 21 reports periorbital rash, conjunctivitis as eye side effects of erlotinib.

Countermeasures for side effects

Skin

A case report in 11 shows that ALA-PDT is effective for skin side effects of erlotinib. Also, a case report in 22 shows that a traditional Chinese medicine called pien tze huang unguentum compositum is effective for skin rash caused by erlotinib.

Gastrointestinal

Regarding the gastrointestinal side effects of erlotinib, 3 suggests that it may be effective to co-administer drugs that inhibit calcium-activated chloride secretion.

Heart

9 describes the combined use of heart failure treatment and continued administration of erlotinib for cardiomyopathy caused by erlotinib.

Comparison between studies

Common points of studies

Many studies have reported skin side effects from erlotinib. 6 , 4 , 18 , 11 , etc.

Differences in studies

The frequency and severity of side effects from erlotinib vary from study to study. For example, 8 reports more gastrointestinal side effects from erlotinib than 3 . Also, cardiomyopathy caused by erlotinib, as seen in 9 , has not been reported in other studies.

Notes on application to real life

Erlotinib is an effective anti-cancer drug, but it also carries the risk of side effects. When considering taking erlotinib, it is important to discuss with your doctor and understand the risks and benefits of the side effects. Also, while taking erlotinib, pay attention to skin and gastrointestinal symptoms, and consult your doctor immediately if you experience any abnormalities.

Limitations of current research

Research on the side effects of erlotinib is still not sufficient. Further research is needed, especially on rare side effects such as cardiomyopathy caused by erlotinib.

Future research directions

The development of new therapies and preventive measures to reduce the side effects of erlotinib is needed. It is also important to develop biomarkers to predict the side effects of erlotinib.

Conclusion

Erlotinib is an effective drug for treating non-small cell lung cancer, but it can cause various side effects. When considering taking erlotinib, it is important to discuss with your doctor and understand the risks and benefits of the side effects. Research on the side effects of erlotinib needs to be continued in the future.

Literature analysis of 24 papers
Positive Content
20
Neutral Content
2
Negative Content
2
Article Type
0
0
0
4
21
2.

Photoresponsive Nanocarriers Based on Lithium Niobate Nanoparticles for Harmonic Imaging and On-Demand Release of Anticancer Chemotherapeutics.

Author: GheataAdrian, GaulierGeoffrey, CampargueGabriel, VuilleumierJérémy, KaiserSimon, GautschiIvan, RiportoFlorian, BeauquisSandrine, StaedlerDavide, DivianiDario, BonacinaLuigi, Gerber-LemaireSandrine

Cancer treatment
Drug delivery efficiency
Reduced side effects
Resistance mitigation

This study developed LNO-CM-ELA NPs, a photo-responsive nanomaterial system for targeted drug delivery and imaging of EGFR-overexpressing carcinomas. The system successfully imaged cells with second harmonic emission and released ELA cargo upon near-infrared light irradiation, inhibiting growth in DU145 cells.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Retrospective Analysis of Skin Toxicity in Patients under Anti-EGFR Tyrosine Kinase Inhibitors: Our Experience in Lung Cancer.

Author: AnnunziataMaria Carmela, FerrilloMaria, CinelliEleonora, PanarielloLuigia, RoccoDanilo, FabbrociniGabriella

Lung cancer treatment
Skin toxicity

Tyrosine kinase inhibitors (TKIs) are effective in treating lung cancer, but can lead to cutaneous toxicities, including rash, xerosis, paronychia, scalp disorders, and hair growth.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Tyrosine kinase inhibitor toxicities: A society of gynecologic oncology review and recommendations.

Author: RimelBobbie J, CraneErin K, HouJune, NakayamaJohn, MacDonaldJennifer, LutzKathleen, MakkerVicky, O'CearbhaillRoisin E

Endometrial cancer treatment
Targeted therapy
TKI toxicity

This review examines common adverse events associated with oral tyrosine kinase inhibitors (TKIs) used for the treatment of gynecologic malignancies and provides readers with an evidence-based review on current uses and strategies for the management of these medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Nevoid melanoma and eruptive nevi from erlotinib.

Author: SeidmanJason S, EichenfieldDawn Z, OrmeCharisse M

Skin cancer

This study reports a case of a woman with metastatic lung cancer in remission who developed eruptive nevi and a nevoid melanoma after two years of treatment with the EGFR inhibitor erlotinib. The authors speculate that a similar mechanism may occur during treatment with EGFR inhibitors as with BRAF inhibitors. They recommend thorough skin examinations for patients undergoing long-term treatment with erlotinib.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Erlotinib-Induced Cardiomyopathy in a Patient with Metastatic Non-Small Cell Lung Cancer.

Author: NagashioKenji, TajiriKazuko, SatoKimi, IedaMasaki

NSCLC treatment
Cardiomyopathy

This case report describes a patient who developed cardiomyopathy during erlotinib treatment for non-small cell lung cancer (NSCLC), highlighting the potential cardiotoxic effects of erlotinib.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Design, Synthesis and Studies on Novel Polymeric Prodrugs of Erlotinib for Colon Drug Delivery.

Author: KumarSahil, SharmaBandna, BhardwajTilak R, SinghRajesh K

Reduced side effects
Targeted drug delivery

This study found that polyphosphazene linked drug conjugates of erlotinib could be promising candidates for the site-specific treatment of colon cancer with the least detrimental side-effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Ocular side effects and trichomegaly of eyelashes induced by erlotinib: a case report and review of the literature.

Author: CelikTuba, KoskerMustafa

Eye lash growth

This report presents a case of erlotinib-induced eyelash trichomegaly and other ocular side effects in a patient with metastatic lung adenocarcinoma. Erlotinib is an epidermal growth factor inhibitor used to treat certain cancers. The report highlights the importance of recognizing this rare side effect to prevent complications, such as corneal ulcers.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Co-encapsulated nanoparticles of Erlotinib and Quercetin for targeting lung cancer through nuclear EGFR and PI3K/AKT inhibition.

Author: GanthalaParimala Devi, AlavalaSateesh, ChellaNaveen, AndugulapatiSai Balaji, BathiniNagendra Babu, SistlaRamakrishna

Increased drug uptake
NSCLC treatment
Ertb resistance

This study evaluated the synergistic effects of combining erlotinib with quercetin in treating non-small cell lung cancer (NSCLC) and developed solid lipid nanoparticles to improve drug delivery and overcome resistance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Afatinib as First-Line Treatment in Asian Patients with EGFR Mutation-Positive NSCLC: A Narrative Review of Real-World Evidence.

Author: LuShun, ShihJin-Yuan, JangTae-Won, LiamChong-Kin, YuYongfeng

Favorable outcomes
NSCLC treatment

Real-world studies have confirmed the effectiveness of afatinib, a second-generation EGFR TKI, as a first-line treatment for EGFR mutation-positive NSCLC in Asian patients. Afatinib has shown favorable outcomes compared to first-generation TKIs and has been effective even in patients with poor prognostic factors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Effects of tyrosine kinase inhibitor therapy on skin toxicity and skin-related quality of life in patients with lung cancer: An observational study.

Author: TsengLi-Chuan, ChenKang-Hua, WangChih-Liang, WengLi-Chueh

NSCLC treatment
reduced quality of life
skin toxicity

Skin toxicity is a common adverse effect of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) used to treat non-small cell lung cancer. This study found that 93.2% of patients experienced skin toxicity, which significantly correlated with poor quality of life. Younger patients and those treated with afatinib were most affected.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

18.

Treatment of Painful Palmoplantar Keratoderma Related to Pachyonychia Congenita Using EGFR Inhibitors.

Author: GrecoCéline, PonsenAnne-Charlotte, Leclerc-MercierStéphanie, SchlatterJoël, CisterninoSalvatore, BoucheixClaude, BodemerChristine

PC treatment
Pain reduction
Acneiform rash
Skin fissures

This study investigated the possibility of treating pachyonychia congenita (PC) patients with painful palmoplantar keratoderma (PPK) by blocking ErbB/Her family signaling with EGFR (Her1) inhibitor erlotinib or lapatinib, a dual EGFR(Her1)/Her2 inhibitor. Oral Her1 or 1/2 inhibitors reduced pain and improved the quality of life for two PC patients, offering promising therapeutic perspectives.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

19.

Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients: A literature review.

Author: BelgioiaLiliana, DesideriIsacco, ErricoAngelo, FranzeseCiro, DaidoneAntonino, MarinoLorenza, FioreMichele, BorghettiPaolo, GretoDaniela, FiorentinoAlba,

TT/IT with RT safety
limited data

The combination of radiotherapy (RT) with targeted therapy/immunotherapy (TT/IT) seems safe in elderly patients, but more data are needed to assess safety and toxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Macrocyclization of Quinazoline-Based EGFR Inhibitors Leads to Exclusive Mutant Selectivity for EGFR L858R and Del19.

Author: AmrheinJennifer A, BeyettTyler S, FengWilliam W, KrämerAndreas, WeckesserJanik, SchaeffnerIlse K, RanaJaimin K, JännePasi A, EckMichael J, KnappStefan, HankeThomas

Kinome selectivity
NSCLC treatment

This study describes the development of a new EGFR inhibitor with improved selectivity for EGFR mutations. Activating mutations in the epidermal growth factor receptor (EGFR) are common drivers of non-small-cell lung cancer (NSCLC). EGFR inhibitors like gefitinib and erlotinib are effective but have off-target effects and can inhibit wild-type EGFR, leading to side effects. This study utilizes a macrocyclic strategy to enhance selectivity for EGFR mutations, potentially improving treatment efficacy while minimizing side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

21.

Newly recognized ocular side effects of erlotinib.

Author: MethvinAmanda B, GausasRoberta E

Conjunctivitis
Epiphora
Lower eyelid ectropion
Periorbital rash

This case report describes a patient who developed a bilateral periorbital rash and conjunctivitis leading to lower eyelid ectropion and epiphora after treatment with erlotinib. The symptoms resolved after discontinuation of the drug, suggesting a reversible side effect of erlotinib.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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