Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erlotinib (Tarceva) is an epidermal growth factor receptor (EGFR) inhibitor, a member of a new group of molecular targeted drugs that combine high efficacy against tumours with less, often self-limiting, toxicity, compared with traditional chemotherapeutics. It is used for treatment of solid-organ tumours, especially as second- or third-line therapy for non-small-cell lung cancer. Dose-related cutaneous side-effects and diarrhoea may be a significant obstacle to treatment compliance. We present two cases with long-lasting acneiform eruptions, complicated by significant impetiginization, resulting in hospitalization in one case. The other patient suffered from sleep-disturbing, itching crusts on the scalp. As the use of EGFR inhibitors is increasing, clinicians should be aware of their side-effects. Early and timely dermatological intervention may diminish adverse events for patients treated with these agents and improve quality of life.
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PMID:Erlotinib-induced florid acneiform rash complicated by extensive impetiginization. 1798 55

Erlotinib is a selective epidermal growth factor receptor(EGFR)tyrosine kinase inhibitor, which shows favorable antitumor activity against chemorefractory lung carcinoma, especially with EGFR gene mutations. We experienced a case in which oxy- genation and performance status improved in with low-dose erlotinib of 100mg/day administered every other day incidental- ly, although a dose of erlotinib 150mg/day daily is encouraged by the RECIST guideline. A 77-year-old male was diagnosed with bronchioloalveolar carcinoma(BAC)and given first-line combination chemotherapy of carboplatin and pemetrexed. However, antitumor activity was not satisfactory. His performance status(PS)was scored as 2 and home oxygen therapy (HOT)was introduced. As second-line chemotherapy, erlotinib was administered 100mg/day daily. However, the patient took the medication every other day at his own discretion, due to severe eruption and itching sensation. Since this case is classified as a nonmeasurable lesion according to the RECIST guideline, it was difficult to measure antitumor activity by tumor size. But improvement of oxygenation, with a performance status score of 0 and normalization of serum CEA level suggested that erlonitib administration of 100mg/day every other day showed antitumor activity.
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PMID:[A case of bronchioloalveolar carcinoma successfully treated with low-dose, alternate-day administration of erlotinib]. 2242 74

Maintenance therapy, commenced immediately after the completion of first-line chemotherapy, is a promising strategy for improving treatment outcomes in patients with non-small-cell lung cancer (NSCLC). The global phase III SequentiAl Tarceva in UnResectable NSCLC (SATURN) study evaluated the efficacy and safety of the epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor erlotinib as maintenance treatment in NSCLC patients without progression after first-line chemotherapy. We report a retrospective subanalysis of Asian patients enrolled in SATURN. Patients with advanced NSCLC with no evidence of progression after four cycles of chemotherapy were randomized to receive erlotinib 150 mg/day or placebo, until progressive disease or limiting toxicity. The co-primary endpoints of SATURN were progression-free survival (PFS) in all patients and in those with positive EGFR immunohistochemistry (IHC) status. Secondary endpoints included overall survival (OS), disease control rate, safety, quality of life (QoL) and biomarker analyses. In total, 126 patients from East and South-East Asian centers were randomized (14% of the intent-to-treat population): 88 from Korea, 28 from China and 10 from Malaysia; one patient was excluded from this analysis due to Indian ethnicity. PFS was significantly prolonged in the erlotinib treatment arm, both overall (hazard ratio [HR]: 0.57; p=0.0067) and in patients with EGFR IHC-positive disease (HR=0.50; p=0.0057). There was a trend towards an increase in OS, which reached statistical significance in the EGFR IHC-positive subgroup (p=0.0233). The overall response rate was significantly higher with erlotinib compared with placebo (24% versus 5%; p=0.0025). Erlotinib was generally well tolerated and had no negative impact on QoL in this subpopulation. The most common treatment-related adverse events were rash, diarrhea and pruritus. Erlotinib was effective and well tolerated in Asian patients, producing benefits consistent with those observed in the overall SATURN population. Maintenance treatment with erlotinib appears to be a useful option for the management of Asian patients with advanced NSCLC without progression after first-line chemotherapy.
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PMID:Efficacy and safety of maintenance erlotinib in Asian patients with advanced non-small-cell lung cancer: a subanalysis of the phase III, randomized SATURN study. 2249 67

Lung cancer is currently one of the leading causes of the cancer-related deaths in the world. Erlotinib and Gefitinib are inhibitors of human epidermal growth factor receptor-1 and the epidermal growth factor receptor tyrosine kinase. The most common adverse events for erlotinib and gefitinib were mild to moderate skin toxicity (rash, itching, and dry skin), gastrointestinal reactions (diarrhea and nausea), and fatigue. Erlotinib induced gastrointestinal bleeding is rare, and dose-related. We are reporting a lung cancer patient who received erlotinib and gefitinib. The patient was sensitive to drug and tumor growth was inhibited. However, adverse reactions appeared as drug treatment continued, including gastrointestinal bleeding.
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PMID:Erlotinib and gefitinib treatments of the lung cancer in an elderly patient result in gastrointestinal bleeding. 2435 36

Pancreatic adenocarcinoma is one of the leading causes of cancer deaths in Japan. Erlotinib plus gemcitabine( GEM) combination therapy provided significant improvements in the overall and progression-free survival in a phase III trial in Canada and a phase II trial in Japan. As a result, this combination therapy was approved for use in Japan. We evaluated the efficacy of erlotinib plus GEM in patients with unresectable pancreatic cancer. GEM at a dose of 1,000 mg/m2 was administered on days 1, 8, and 15 in a 4-week cycle. Erlotinib was taken orally at 100 mg/day until disease progression or unmanageable toxicity. Between October 2011 and April 2013, 9 patients were enrolled. The mean age was 62.3 years (range, 48-70 years), and 66.7% of patients were men. Eight patients had no prior therapy. All patients had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0. Eight patients had metastatic and 1 had locally advanced disease. Five patients had a history of smoking. The median duration of erlotinib administration was 133 days, and the median dose intensity was 100 mg/day, with the majority of patients( 88.9%) receiving 100% of the relative dose intensity. The median duration of GEM treatment was 5 cycles, and its median dose intensity was 890 mg/m2/week, with approximately half of the patients (66.7%) receiving >85% of the relative dose intensity. The most frequently reported adverse event was skin rash, which occurred in 44.4% of the patients. Other common non-hematological adverse events included facial edema, diarrhea, nausea, depilation, pruritus, and cholangitis. Most patients experienced some degree of hematological toxicity, with Grade 3 or 4 neutropenia, leukopenia, and anemia. Interstitial lung disease was not observed. The median overall survival was 7.63 months, and the 1-year survival rate was 15%. The median progression-free survival was 5.60 months. The overall response rate was 11.1%,and the disease control rate was 88.9% [complete response (CR), n =0; partial response( PR), n=1; stable disease( SD), n=7]. In conclusion, erlotinib plus GEM combination therapy is well tolerated and associated with efficacy and survival outcomes.
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PMID:[Erlotinib plus gemcitabine combination therapy in patients with unresectable advanced pancreatic cancer - a single-institution experience]. 2439 54

Erlotinib is an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor approved for the treatment of non-small cell lung cancer and when combined with gemcitabine for pancreatic cancer. Dose reduction of erlotinib in patients with severe hepatic impairment has been established. We present the case of a male patient suffering from an adenocarcinoma of the pancreas with metastases in the liver and lung, whose disease progression led to highly elevated bilirubin levels of >14 mg/dl accompanied by icterus and pruritus. Despite the known contraindication, the patient agreed to be treated with 150 mg erlotinib p.o. per day. We performed therapeutic drug monitoring of erlotinib on day 1 after the first ingestion of erlotinib and then over a period of 19 days. One-compartment pharmacokinetics on day 1 were calculated, and, based on these data, a pharmacokinetic simulation for the following 19 days was run. On day 1 after the first erlotinib ingestion, plasma concentrations were identical to those described in the literature. On the following days, erlotinib plasma concentrations remained at a similar order of magnitude after daily ingestion. Compared with published data, OSI420 plasma concentrations were clearly higher from day 1 to 16. Due to disease progression, the last intake of erlotinib was on day 16, but plasma concentrations of the drug and metabolite increased excessively thereafter. The data give evidence that total bilirubin levels up to 14 mg/dl do not necessarily cause elevated plasma concentrations of erlotinib when given in doses of 150 mg per day.
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PMID:Disposition of Erlotinib and Its Metabolite OSI420 in a Patient with High Bilirubin Levels. 2447 24