Re-administration of gefitinib following diffuse interstitial lung disease in a patient with advanced lung adenocarcinoma: A case report and review of the literature.

Interstitial lung disease (ILD) is a severe adverse effect of gefitinib treatment. Re-administration of gefitinib to patients suspected of suffering from gefitinib-induced ILD requires cautious consideration. In the majority of cases, gefitinib is not re-administered to such patients. The present study reports a case of advanced lung adenocarcinoma, where the patient developed gefitinib-induced ILD and gefitinib was re-administered at 3.5 months after discontinuation of gefitinib treatment. Initially, the patient achieved partial clinical remission, but developed diffuse ILD following gefitinib administration for 5 months. Following the onset of ILD, gefitinib was discontinued immediately and low-dose corticosteroids were administered at the early stages of ILD. Subsequent to recovery from the lung injury, gefitinib was re-administered along with N-acetylcysteine. The patient presented with good lung adenocarcinoma control and did not experience a recurrence of ILD for >16 months. Thus, early discontinuation and gefitinib re-administration with N-acetylcysteine may be a potential novel treatment strategy for gefitinib-induced ILD.