gms | German Medical Science

Between January and October 2005 we treated 49 NSCLC patients with locally advanced or metastatic disease with erlotinib. Of those there are still 9 patients under treatment and 3 are being treated for more than 7 months. A 67 years old male patient presented with persistent cough and weakness and increasing bilateral pulmonary infiltration despite antibiotic treatment. The diagnosis resulted in a BAC with a bilateral lung lobe involvement. A chemotherapy consisting of Gemcitabine and Carboplatin was initiated but had to be stopped due to massive progressive disease and dramatically reduced performance status after two months of therapy. Therefore erlotinib treatment was started and after only two weeks of treatment a significant reduction in cough and a resolved dyspnoe was to be found. 4 weeks after start of erlotinib treatment a normalization of the lung function was seen and additional 4 weeks later thoracic CT revealed a nearly complete remission of the tumor with discrete remaining findings. The patient developed a rash Grade 3 and erlotinib dose had to be reduced to 100 mg and this treatment is still ongoing. After ten weeks of treatment the skin side effects disappeared almost completely. In summary we can confirm the possibility of a very fast response to an erlotinib treatment for patients with a fulminant progression of the NSCLC and bronchiolo-alveolar carcinoma under chemotherapy.