Gefitinib-Induced Severe Dermatological Adverse Reactions: A Case Report and Pharmacogenetic Profile

Gefitinib is a selective inhibitor of the epidermal growth factor receptor that is used to treat advanced and metastatic non-small cell lung cancer (NSCLC). Dermatological adverse reactions are most commonly associated with gefitinib treatment. The cause of adverse reactions in individuals is multif...

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Bibliographic Details
Published in:Pharmaceuticals (Basel, Switzerland) Switzerland), 2024-08, Vol.17 (8), p.1040
Main Authors: Morau, Mariana Vieira, Seguin, Cecilia Souto, Perroud Junior, Mauricio Wesley, Dagli-Hernandez, Carolina, Pincinato, Eder de Carvalho, Moriel, Patricia
Format: Article
Language:English
Subjects:
ABCB1
adverse drug reaction
Cancer therapies
Case Report
Case reports
cytochrome P450 enzyme system
Drug interactions
Enzymes
gefitinib
Genetic testing
Genotype & phenotype
Kinases
Liver
Lung cancer
Metabolism
Patients
pharmacogenetics
Pharmacokinetics
Polymorphism
skin rash
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Summary:Gefitinib is a selective inhibitor of the epidermal growth factor receptor that is used to treat advanced and metastatic non-small cell lung cancer (NSCLC). Dermatological adverse reactions are most commonly associated with gefitinib treatment. The cause of adverse reactions in individuals is multifactorial. Pharmacogenetics is an effective tool to detect such adverse reactions. This case report describes a female patient with NSCLC who was administered gefitinib at a dose of 250 mg/day. However, due to severe adverse dermatological reactions, the treatment was interrupted for 15 d and antibiotic therapy was administered to manage the skin rashes, maculopapular rashes, and hyperpigmentation. Treatment adherence was adequate, and no drug interactions were detected. A pharmacogenetic analysis revealed homozygosity in the ATP-binding cassette rs1128503 (c.1236A>G), heterozygosity in rs2231142 (c.421G>T) and rs2622604 (c.-20+614T>C), and a non-functional variant of the cytochrome P450 family 3, subfamily A, member 5 ( ). The relationship between altered genetic variants and the presence of adverse reactions induced by gefitinib is still controversial. Overall, this case report highlights the importance of continuing to study pharmacogenetics as predictors of adverse drug reactions.
ISSN:1424-8247
1424-8247
DOI:10.3390/ph17081040