Probable drug-drug interaction between erlotinib and amiodarone causes severe neurotoxicity in a patient with advanced lung cancer

Anticancer Drugs. 2018 Apr;29(4):380-383. doi: 10.1097/CAD.0000000000000600.

Abstract

Drug-drug interactions (DDIs) are of great concern in the treatment of cancer, especially when target therapies, such as tyrosine kinase inhibitors, are being used. Here, we report a case of probable DDI between erlotinib and amiodarone leading to severe neurotoxicity. Amiodarone inhibits P-glycoprotein (P-gp), for which erlotinib is a substrate. P-gp is an important drug transporter that is involved in limiting the blood-brain barrier penetration of erlotinib. Clinicians should be aware of emerging data characterizing the effect of the P-gp transport system on drug exposure and its potential for DDI.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / antagonists & inhibitors
  • Amiodarone / adverse effects*
  • Amiodarone / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / radiotherapy
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / radiotherapy
  • Disease Progression
  • Drug Interactions
  • Erlotinib Hydrochloride / adverse effects*
  • Erlotinib Hydrochloride / therapeutic use
  • Humans
  • Induction Chemotherapy
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Paralysis / etiology
  • Radiotherapy
  • Withholding Treatment

Substances

  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Erlotinib Hydrochloride
  • Amiodarone