Gefitinib隔日投与が奏効した術後再発肺癌

Postoperative Recurrent Lung Cancer Successfully Treated with Alternate Day Administration of Gefitinib

分子標的薬であるgefitinibは上皮成長因子受容体（EGFR）遺伝子変異陽性の非小細胞肺癌治療におけるキードラッグであるが，有害事象により投与中止を余儀なくされることも少なくない．われわれは，gefitinib投与により皮膚障害を生じ，隔日投与としたが長期抗腫瘍効果を得られた症例を経験したので報告する．

A 57-year-old man was referred to our department for further examination for chest abnormal shadow in the right upper lobe. Positron emission tomography （PET）-computed tomography （CT） showed abnormal accumulation of fluorodeoxyglucose （FDG）. Because of lung cancer could not be denied, he underwent right upper lobectomy and the nodule was diagnosed as adenocarcinoma by pathology. A chest CT performed one and a half years after surgery showed multiple lung nodules and was diagnosed as recurrence. Since the deletion mutation of exon19 was confirmed in the epidermal growth factor receptor （EGFR） gene mutation analysis, gefitinib （250 mg/day） daily administration was started. Multiple lung nodules were almost banished promptly, but severe skin rash developed, so gefitinib administration was reduced to 250 mg/every second day and the skin rush disappeared. In spite of reduced dose antitumor effect was maintained for two years without recurrence of skin rash.