Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (12): 32-37.doi: 10.6040/j.issn.1671-7554.0.2024.0506

• Clinical Pharmaceutical Research and Evaluation • Previous Articles    

A rare case of lung adenocarcinoma complicated with bullous pemphigoid successfully treated with EGFR-TKI almonertinib

YANG Chuang1, ZHANG Rongyu1, SONG Bin2, WANG Chengjun1,3, ZHAO Wen3, XUAN Tiantian4, LI Jisheng3   

  1. 1. The First Clinical College of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Dermatology, Zhangqiu District Maternal and Child Health Hospital, Jinan 250200, Shandong, China;
    3. Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    4. Department of Medical Oncology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266000, Shandong, China
  • Published:2024-12-09

PDF (PC)

24

Abstract: Objective To explore the relationship between lung adenocarcinoma with EGFR sensitizing mutation and bullous pemphigoid, as well as the benefit of almonertinib. Methods Clinical data from a case of lung adenocarcinoma complicated with bullous pemphigoid was collected. Pathological and molecular diagnosis was confirmed through histopathological examination and next-generation sequencing genetic testing. Literature review was then conducted to summarize and analyze the diseases pathogenesis and treatment options. Results The diagnosis of metastatic lung adenocarcinoma with bullous pemphigoid was established through imaging and histopathology examination. Next-generation sequencing revealed a sensitizing mutation of exon 19 deletion in the EGFR gene. The patient was treated with almonertinib with regular chest CT evaluations. The anti-tumor treatment efficacy was assessed to be partial response, and the skin lesions continued to improve with no significant adverse reactions. Conclusion Targeted therapies can be considered in patients with EGFR-mutant metastatic lung adenocarcinoma complicated by bullous pemphigoid and almonertinib demonstrates good efficacy and safety.

Key words: Lung adenocarcinoma, Bullous pemphigoid, Almonertinib, Targeted therapy

CLC Number: 

  • R734.2
[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2] Gould Rothberg BE, Quest TE, Yeung SJ, et al. Oncologic emergencies and urgencies: a comprehensive review[J]. CA Cancer J Clin, 2022, 72(6): 570-593.
[3] Balestri R, Magnano M, la Placa M, et al. Malignancies in bullous pemphigoid: a controversial association[J]. J Dermatol, 2016, 43(2): 125-133.
[4] Baum S, Steinberg S, Tzanani I, et al. Prevalence, spectrum and clinical implications of malignancies in patients with bullous pemphigoid[J]. Acta Derm Venereol, 2023, 103: adv00888. doi:10.2340/actadv.v103.3979.
[5] Karakioulaki M, Eyerich K, Patsatsi A. Advancements in bullous pemphigoid treatment: a comprehensive pipeline update[J]. Am J Clin Dermatol, 2024, 25(2): 195-212.
[6] Ogawa H, Sakuma M, Morioka S, et al. The incidence of internal malignancies in pemphigus and bullous pemphigoid in Japan[J]. J Dermatol Sci, 1995, 9(2): 136-141.
[7] Albadri Z, Thorslund K, Häbel H, et al. Increased risk of squamous cell carcinoma of the skin and lymphoma among 5, 739 patients with bullous pemphigoid: a Swedish nationwide cohort study[J]. Acta Derm Venereol, 2020, 100(17): adv00289. doi:10.2340/00015555-3622.
[8] Ahmed AR, Kalesinskas M, Kooper-Johnson S. Paraneoplastic autoimmune Laminin-332 syndrome(PALS): anti-Laminin-332 mucous membrane pemphigoid as a prototype[J]. Autoimmun Rev, 2023, 22(10): 103444. doi:10.1016/j.autrev.2023.103444.
[9] Kridin K, Hammers CM, Ludwig RJ, et al. Risk of solid malignancies in bullous pemphigoid: a large-scale population-based cohort study[J]. J Dermatol, 2021, 48(3): 317-323.
[10] Varpuluoma O, Jokelainen J, Huilaja L, et al. Solid and hematological malignancies in patients with bullous pemphigoid: a national cohort study[J]. J Am Acad Dermatol, 2024, 90(2): 399-401.
[11] Atzmony L, Mimouni I, Reiter O, et al. Association of bullous pemphigoid with malignancy: a systematic review and meta-analysis[J]. J Am Acad Dermatol, 2017, 77(4): 691-699.
[12] Ong E, Goldacre R, Hoang U, et al. Associations between bullous pemphigoid and primary malignant cancers: an English national record linkage study, 1999-2011[J]. Arch Dermatol Res, 2014, 306(1): 75-80.
[13] Chen CT, Hu HY, Chang YT, et al. Cancer is not a risk factor for bullous pemphigoid: 10-year population-based cohort study[J]. Br J Dermatol, 2019, 180(3): 553-558.
[14] Shen WC, Chiang HY, Chen PS, et al. Risk of all-cause mortality, cardiovascular disease mortality, and cancer mortality in patients with bullous pemphigoid[J]. JAMA Dermatol, 2022, 158(2): 167-175.
[15] Lakhdar N, El Khattabi W, Lahroussi M, et al. Cancer pulmonaire à petites cellules associé à une pemphigoïde bulleuse paranéoplasique[J]. Rev De Pneumol Clin, 2014, 70(3): 169-172.
[16] Safini F, Tawfiq N. Pemphigoïde bulleuse paranéoplasique associée à un cancer bronchique[J]. Pan Afr Med J, 2015, 21: 248. doi: 10.11604/pamj.2015.21.248.6034.
[17] Janah H, Mahhou M, Souhi H, et al. Bullous pemphigoid revealing bronchial carcinoma[J]. Pan Afr Med J, 2014, 19: 45. doi:10.11604/pamj.2014.19.45.5160.
[18] Vroman DT, Breckenridge RR, Solomon KD, et al. Bronchogenic squamous cell carcinoma presenting as cicatrizing conjunctivitis[J]. Cornea, 2006, 25(5): 611-613.
[19] Das A, Das S, Das SK, et al. A case of paraneoplastic bullous pemphigoid in association with squamous cell carcinoma of lung[J]. J Postgrad Med, 2015, 61(3): 197-199.
[20] Shrestha P, George MK, Baidya S, et al. Bullous pemphigoid associated with squamous cell lung carcinoma showing remarkable response to carboplatin-based chemotherapy: a case report[J]. J Med Case Rep, 2022, 16(1): 184. doi:10.1186/s13256-022-03323-9.
[21] Kramer N, Müller G, Zierold S, et al. Checkpoint inhibitor-induced bullous pemphigoid differs from spontaneous bullous pemphigoid[J]. J Eur Acad Dermatol Venereol, 2024, 38(8): e722-e728.
[22] Naidoo J, Schindler K, Querfeld C, et al. Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1[J]. Cancer Immunol Res, 2016, 4(5): 383-389.
[23] Stingeni L, Bianchi L, Minotti V, et al. Erlotinib-induced bullous pemphigoid[J]. J Am Acad Dermatol, 2012, 67(5): e199-e201.
[24] Tang K, Seo J, Tiu BC, et al. Association of cutaneous immune-related adverse events with increased survival in patients treated with anti-programmed cell death 1 and anti-programmed cell death ligand 1 therapy[J]. JAMA Dermatol, 2022, 158(2): 189-193.
[25] 张荣雨,赵文,李洪欣,等.奥西替尼联合化疗一线治疗EGFR-RAD51融合突变转移性肺腺癌1例[J]. 山东大学学报(医学版), 2024, 62(5): 116-120.
[26] Lu S, Dong XR, Jian H, et al. AENEAS: a randomized phase III trial of aumolertinib versus gefitinib as first-line therapy for locally advanced or MetastaticNon-small-cell lung cancer with EGFR exon 19 deletion or L858R mutations[J]. J Clin Oncol, 2022, 40(27): 3162-3171.
[27] Lu S, Wang QM, Zhang GJ, et al. Efficacy of aumolertinib(HS-10296)in patients with advanced EGFR T790M+ NSCLC: updated post-national medical products administration approval results from the APOLLO registrational trial[J]. J Thorac Oncol, 2022, 17(3): 411-422.
[28] 邓姝婷,姚煦.肿瘤靶向药物相关皮肤不良反应及发生机制[J].中华临床免疫和变态反应杂志, 2024, 18(2): 181-189. DENG Shuting, YAO Xu. Cutaneous adverse reactions associated with targeted cancer therapy and its pathogenesis[J]. Chinese Journal of Allergy & Clinical Immunology, 2024, 18(2): 181-189.
[1] WANG Jingting, WANG Jing, LU Yi, LI Jingtan, LI Qiang, JIA Yanfei, MA Xiaoli. Expression and correlation of α5-nAChR and MHC-I in lung adenocarcinoma [J]. Journal of Shandong University (Health Sciences), 2024, 62(5): 72-78.
[2] MENG Jianli, WANG Qinggang. Expression and potential mechanism of VPS72 in lung adenocarcinoma/ squamous cell carcinoma by integrated bioinformatics analysis [J]. Journal of Shandong University (Health Sciences), 2023, 61(8): 40-49.
[3] LIU Shibiao, ZHANG Shujun, LI Peilong, DU Lutao, WANG Chuanxin. The cg20657709 site methylation in the early detection of lung adenocarcinoma [J]. Journal of Shandong University (Health Sciences), 2023, 61(4): 18-25.
[4] ZHAO Qidi, WANG Kai, ZHAO Xiaogang, YAN Tao, WANG Yadong, DU Jiajun. Constructing and validating a prognostic model for patients with stage IIIB non-small cell lung cancer based on SEER database [J]. Journal of Shandong University (Health Sciences), 2023, 61(10): 23-37.
[5] WANG Fuli, SUN Yinping, QIN Jie, RONG Jiansheng. Efficacy of DC-CIK cells combined with EGFR-TKI for 35 elderly patients with advanced EGFR-mutant lung cancer [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 110-117.
[6] ZHENG Haotian, WANG Guanghui, ZHAO Xiaogang, WANG Yadong, ZENG Yukai, DU Jiajun. A prognostic risk model for LKB1 mutant lung adenocarcinoma based on aberrant DNA methylation sites [J]. Journal of Shandong University (Health Sciences), 2022, 60(3): 51-58.
[7] PANG Zhaofei, LIU Yong, ZHAO Xiaogang, YAN Tao, CHEN Xiaowei, DU Jiajun. Construction of a stemness-based scoring model predicting the efficacy of immunotherapy in lung adenocarcinoma based on public databases [J]. Journal of Shandong University (Health Sciences), 2021, 59(11): 19-28.
[8] CHAI Xiaoxue, YE Hui, LYU Xinran, DING Xuchao, ZHEN Qiulai, DU Juan, CAO Lili. Prognostic value of POU4F3 in 118 patients with lung adenocarcinoma and its effect on migration of lung adenocarcinoma cells [J]. Journal of Shandong University (Health Sciences), 2021, 59(11): 8-18.
[9] Chuanzhu YAN,Wei WANG,Kunqian JI,Yuying ZHAO. Mitochondrial dysfunction and related brain diseases [J]. Journal of Shandong University (Health Sciences), 2020, 1(8): 34-41.
[10] Anjing CHEN,Xun ZHANG. The new strategies of targeting SUMOylation in the treatment of glioma [J]. Journal of Shandong University (Health Sciences), 2020, 1(8): 88-94.
[11] YANG Xiuting, LIU Qigong, ZUO Ping, LIU Zhengxiang, ZUO Houjuan. Effect of CD151-MUT mutation on migration of lung adenocarcinoma cell line A549 and its mechanism [J]. Journal of Shandong University (Health Sciences), 2020, 58(3): 81-86.
[12] WANG Jianxiang, GU Runxia. Advances in targeted therapy for acute myeloid leukemia [J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 6-12.
[13] FENG Alei, DONG Qing, PANG Jiaohui, YIN Jiani, LI Qiang, HAN Junqing, YANG Zhe. Exploring molecular characteristics of esophageal squamous cell carcinoma based on next-generation sequencing [J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 80-85.
[14] ZHENG Qingyue, ZHAO Qiuhong, QU Xiangyun, DONG Zhaonan, MA Xueqing, JIA Yunli. Diagnosis value of serum exosome miR-205-5p/miR-152-5p on early non-small cell lung cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(10): 101-106.
[15] WANG Haitao. Development of precision medicine in the treatment of castration-resistant prostate cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(1): 30-35.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd