Abstract YO35
Case summary
Background - Epidermal growth factor receptors have been commonly associated with rash, diarrhoea and nail changes
Case details - A 57 year female, a known case of EGFR positive metastatic Adenocarcinoma of the lung with Pleural, liver and bone involvement, who had been started on Gefitinib 250 mg once daily upfront eight months ago presented with complaints of involuntary movements involving the jaw and neck since the past 15 days. She had to take resort to clenching her teeth tightly in an attempt to control the movements which interfered with mastication and activities of daily living. They were not suppressed during sleep. She also reported bite marks on the lips and tongue along with mucosal ulcerations. The movements did not involve the upper or lower extremity. There was a positive history of reduced oral intake, however she did not report any difficulty upon swallowing. There were no signs of intracranial metastasis. She had also undergone ICD insertion for right sided malignant pleural effusion and had received palliative radiotherapy for vertebral metastasis (L1-L5). CT scan done at the time of presentation was suggestive of a right hilar mass with pleural, hepatic and bone involvement. Response assessment CT (performed after seven months of upfront EGFR Tyrosine kinase inhibitor) was suggestive of significant interval change in the Lung mass with reduction in size and number of liver lesions. MRI performed after development of abnormal movements was not suggestive of any intracranial pathology. The patient had been started on Gabapentin for targeting the neuropathic component of her bone pain, so a diagnosis of Gabapentinoid induced movement disorder was also considered. She was referred to the medical oncologist, where her EGFR Tyrosine kinase inhibitor was discontinued.
Discussion - She reported an improvement in her symptoms after the discontinuation of the Gefitinib (small cell transformation was suspected). A WHO-UMC category of possible/likely causation and score of 3 was obtained on Naranjo’s algorithm (possible Adverse drug reaction). Gabapentinoids were continued on the subsequent visit. This is one of the first reports of a movement disorder due to a EGFR tyrosine kinase inhibitor.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
237P - PARP inhibitor in platinum resistant ovarian cancer: Single center real world experience
Presenter: Saphalta Baghmar
Session: Poster display session
Resources:
Abstract
238P - Laparoscopic cytoreduction in low disease burden, advanced-stage ovarian cancers: Experience from a tertiary cancer center
Presenter: Vikas Gupta
Session: Poster display session
Resources:
Abstract
239P - Impact of counseling on patient reported sexual adjustment following chemoradiation and brachytherapy for cervical cancer
Presenter: Vibhay Pareek
Session: Poster display session
Resources:
Abstract
240P - Morbidity and mortality of cervical cancer in the Republic of Kazakhstan
Presenter: Almagul Zhabagina
Session: Poster display session
Resources:
Abstract
241P - Impact of genomic alterations and HPV genotypes on clinical outcomes of Japanese patients with locally advanced cervical cancer
Presenter: Ikumi Kuno
Session: Poster display session
Resources:
Abstract
242P - Impact of combined interstitial and intracavitary brachytherapy in locally advanced cervical cancer: A survival and toxicity profile assessment
Presenter: Vibhay Pareek
Session: Poster display session
Resources:
Abstract
243P - Cervical cancer screening in sub-urban area of Banten and factor associated with uptake of screening
Presenter: Prio Wibisono
Session: Poster display session
Resources:
Abstract
245P - Factors influencing adherence to cryotherapy following positive VIA result as cervical cancer prevention in Temanggung, Central Java, Indonesia
Presenter: Herindita Puspitaningtyas
Session: Poster display session
Resources:
Abstract
246P - The main of reasons of advanced stage cervical cancer in Uzbekistan
Presenter: Zakhirova Nargiza
Session: Poster display session
Resources:
Abstract
247P - Role of ADC values in assessing response after chemoradiotherapy in cervix cancer and in identifying residual disease
Presenter: Venkata Pradeep Babu Koyyala
Session: Poster display session
Resources:
Abstract