Dramatic Improvement of Severe Cicatricial Ectropion after Discontinuing Long-Term Erlotinib Therapy in a Patient with Lung Cancer

Abstract

There is no consensus on the choice of systemic and ophthalmic treatment for patients who develop ocular toxicity with erlotinib in the few cases reported previously. Various ocular complications related to erlotinib have been reported, with one of the most serious being corneal perforation. Our patient was at risk of potential corneal perforation because of severe cicatricial ectropion and diffuse punctate corneal epitheliopathy. Therefore, erlotinib treatment was temporarily discontinued with the approval of the oncology department and the patient was closely followed. She was prescribed steroid eye ointment, single-use preservative-free artificial tears, and eye lubricant gel to protect the ocular surface. On day 4 of treatment, the patient’s findings were significantly improved. After 1 week, the cicatricial ectropion had dramatically improved and the patient’s complaints were completely resolved. To our knowledge, there is no case report of a patient with both ocular toxicity after long-term use that shows dramatic improvement with drug cessation, and severe cicatricial ectropion affecting the entire lower eyelid. Here, we described a patient who used erlotinib for 3 years due to non-small cell lung cancer and developed severe cicatricial ectropion which improved dramatically within one week of temporarily discontinuing erlotinib and discussed the possible reasons. Although ocular complications with erlotinib are usually encountered early in treatment, it should be kept in mind that erlotinib-related ocular complications may also arise with long-term use.

Effect of Erlotinib Combined with Radiotherapy on Proliferation and Apoptosis of Human Non-Small Cell Lung Cancer Cells and its Possible Mechanism Exploration

“…Clinical studies have found that Epidermal Growth Factor Receptor (EGFR) gene exon 19 mutations are the most typical in NSCLC, which can trigger enhanced activity of EGFR tyrosine kinase, promote biological behaviors such as tumor cell implantation, metastasis and invasion and then lead to tumor progression [3] . Because NSCLC patients do not have obvious clinical symptoms in the early stage of the disease, most patients have progressed to advanced pathological stage when lung cancer is diagnosed, and distant metastases have occurred, and the best time for surgical treatment is lost [4] . In recent years, with the continuous improvement of medical technology, molecularly targeted therapy drugs have played an important role in the drug treatment of patients with EGFR-mutated NSCLC, among which small molecule tyrosine kinase inhibitors can be multi-targeted antiangiogenic and have significant clinical effects in preclinical studies [5] .…”