Efficacy of erlotinib in hemodialysis patients

Over the past few years, there has been a significant change in the standard of care for patients with metastatic nonsmall-cell lung cancer (NSCLC). This resulted from the identification of several mutations that small molecule tyrosine kinase inhibitors (TKIs) may target. One of the first-line treatments for patients with metastatic NSCLC that contains an epidermal growth factor receptor (EGFR) mutation is erlotinib. However, the majority of TKI trials did not involve particular populations, such as individuals with end-stage renal disease (ESRD). Here, we present a patient with newly-diagnosed EGFR-mutated metastatic NSCLC with ESRD, who was on regular hemodialysis. Erlotinib therapy (150 mg daily) achieved a near-complete response in the patient, with significant shrinkage of his tumor. His report demonstrates that erlotinib is safe in NSCLC patients with ESRD. Erlotinib is a safe and recommended treatment for patients with NSCLC who have reduced renal function, according to the evidence presented in our case and several other case reports.