One case report of serious adverse effect of erlotinib and tacrolimus in lung cancer patients after lung transplantation and literature review
WANG Fang-zhou
ZHANG Ming-yue
WANG Ren-tao
SHE Dan-yang
Abstract：A middle-aged male patient, with the history of 11 years after the right lung transplantation and long-term use of tacrolimus (1 mg, bid), was hospitalized because of the discovery of lung shadows. After diagnosed of left upper lung adenocarcinoma stage Ⅳ ,the patient received erlotinib (150 mg, qd). Later, severe deterioration of kidney function, diarrhea, vomiting and other adverse reactions were found during medication. The highest concentration of serum creatinine was 258.9μmol·L-1. Tacrolimus blood concentration was slightly elevated (5.7 ng·mL-1). The drug interaction of erlotinib and tacrolimus may be related with these adverse reactions. We reduced the tacrolimus dose and discontinued erlotinib. Diarrhea, vomiting and other symptoms were rapidly relieved. Renal function of the patient returned to the level prior to admission (166.9 μmol·L-1). The patient did not appear adverse drug reaction later. The molecularly targeted therapy drugs and immunosuppressive agents commonly used in clinical practice are all metabolized by CYP450, both of them are also the substrate of CYP450. The combined use of these drugs often aggravates each other's adverse reactions. This article reviewed the related literature.
Keywords：TacrolimusErlotinibDrug interactionLung adenocarcinomaAdverse drug reaction
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 251-254,258 )