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
426P - Impaired quality of life of caregivers of patients with gastrointestinal cancer undergoing palliative chemotherapy
Presenter: Nobumichi Takeuchi
Session: Poster display session
Resources:
Abstract
427P - Sahai: A restorative support to address unmet needs of women with cancer – impact on quality of life
Presenter: Poonam Maurya
Session: Poster display session
Resources:
Abstract
428P - A pilot study on comparative efficacy of tramadol or eutectic mixture of local anaesthetics (prilocaine plus lignocaine) in preventing bone marrow aspiration associated pain
Presenter: Bipinesh Sansar
Session: Poster display session
Resources:
Abstract
429P - Skin pathologic change evaluation of the patients who had EGFR inhibitor-related skin adverse events
Presenter: Sung Yong Oh
Session: Poster display session
Resources:
Abstract
430P - Emetic risk of carboplatin plus pemetrexed is higher than that of carboplatin plus paclitaxel in patients with lung cancer: A propensity score-matched analysis
Presenter: Koichi Matsuo
Session: Poster display session
Resources:
Abstract
431P - An in vitro evaluation of CYP2D6 enzymatic inhibition activities of a Chinese herbal medicine formulation (Xiang Bei Yangrong Tang) for the management of cancer-related fatigue
Presenter: Ning Yi Yap
Session: Poster display session
Resources:
Abstract
432P - Chemotherapy induced extravasation: Incidence and possible predictors
Presenter: Shalaka Somayaji
Session: Poster display session
Resources:
Abstract
433P - Prospective outcomes of adolescent and young adult (AYA) patients received treatment from a tertiary cancer hospital in Bangladesh
Presenter: Abdullah Al Mamun Khan
Session: Poster display session
Resources:
Abstract
434P - Pneumonitis induced antineoplastic agents: Mortality and risk factors in 129 consecutive cases
Presenter: Sawako Kaku
Session: Poster display session
Resources:
Abstract
435P - Telephonic communication in palliative care for better management of terminal cancer patients in rural India: An NGO based approach
Presenter: NABANITA MANDAL
Session: Poster display session
Resources:
Abstract