Lung Carcinoma Developing Afatinib-Associated Skin Reactions

Abstract

ABS TRACT Afatinib is an irreversible second-generation tyrosine kinase inhibitor. It is used to treat epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma. The most well-known side effects associated with afatinib are diarrhea, rashes or acne and stomatitis. Herein, we present a case of skin toxicity that developed in the late phase of afatinib treatment. A 51-year-old, non-smoker woman diagnosed with EGFR deletion-19 mutant advanced lung adenocarcinoma. Afatinib was initiated as the first-line treatment. At the twelfth treatment month, Grade-2 acneiform dermatitis, paronychia, and hand-foot syndrome developed. Despite the interruption or discontinuation of afatinib treatment and local/systemic steroid treatments, the lesions did not regress. The patient was responsive to afatinib; however, the treatment was discontinued in the eighteenth month of treatment. The treatment response may be predicted by the severity of skin toxicities owing to afa-tinib. They occur in the early treatment phase and are commonly observed at the Grade 1-2 level.