ORAL AND NAIL BED ULCERS CAUSED BY AFATINIB (MONOCLONAL ANTIBODY) IN LUNG CANCER

Abstract

Medicated oral ulcers are often observed in patients who use antineoplastic drugs. Afatinib is an orally administered, irreversible inhibitor of the ErbB family of tyrosine kinases. It is the first-line treatment of patients with non–small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR) mutations. During the treatment, some adverse effects such as epistaxis, diarrhea, nausea, vomiting, aphthous stomatitis, rash, acneiform dermatitis, pruritus, and xeroderma can be observed. We present a case of a 63-year-old female patient with advanced EGFR-mutated NSCLC and started treatment with oral afatinib 40 mg daily. On clinical examination there were atopic lesions located on the mucosa of the soft palate, lips, and tongue as well as involvement of the nails. This case demonstrates aphthous stomatitis as an adverse effect of antineoplastic medication that should be placed as a differential diagnosis in patients who use afatinib.