Reactions 1328 - 20 Nov 2010

SVandetanib

Photosensitivity in an elderly patient: case reportAn 80-year-old woman developed photosensitivity

following treatment with vandetanib for non-small cell lungcancer.

The woman was diagnosed with non-small cell lungcancer in January 2009 and enrolled in an experimentalclinical trial in March 2009, examining the use ofgemcitabine and oral vandetanib 300 mg/day. She wasadmitted in May 2009 with erythematous edematous scalylesions on the bilateral forearms, head and neck, decolleteand legs (National Cancer Institute Common ToxicityCriteria grade 2). Focal erosions were present, but nobullous lesions. All lesions were only on photo-exposedareas. Severe pruritus was subjectively noted. Elevatedlevels of C-reactive protein were noted, with no detectionof eosinophilia or hyper-IgE. Following a skin biopsy, alichenoid dermatitis with eosinophils and mild spongiosisand pigment incontinence was detected.

The woman continued her gemcitabine, stoppedvandetanib, and received steroid and systemicantihistaminic treatment. She was advised to avoid sunexposure. The lesions were less edematous and infiltratedat a 3 month follow-up, and extensive post-inflammatorypigmentation was noted. There was subsequent rapidworsening of her general conditions, meaning photo testscould not be performed.

Author comment: "The occurrence of cutaneous lesionsarising in photo-exposed areas following vandetanibtreatment and the progressive disappearance after itsdiscontinuation, together with the polycyclic structure andthe low molecular weight of vandetanib point to a possibleinvolvement of this molecule."Fava P, et al. A rare vandetanib-induced photo-allergic drug eruption.Dermatologic Therapy 23: 553-555, No. 5, Sep-Oct 2010. Available from: URL:http://dx.doi.org/10.1111/j.1529-8019.2010.01360.x - Italy 803043606

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Reactions 20 Nov 2010 No. 13280114-9954/10/1328-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved