Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC
EGFR-TKI is widely used for EGFR-mutant NSCLC patients. Bleeding is reported as a neglected adverse effect induced by EGFR-TKI. Female patients with lung adenocarcinoma have a high frequency of EGFR mutations. This study investigated the effect of EGFR-TKI on the menstrual cycle, especially on bleed...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.805538/full |
| _version_ | 1818468016029958144 |
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| author | Min Yu Xiaoyu Li Xiaoyu Li Xueqian Wu Weiya Wang Yanying Li Yan Zhang Shuang Zhang Yongsheng Wang Yongsheng Wang |
| author_facet | Min Yu Xiaoyu Li Xiaoyu Li Xueqian Wu Weiya Wang Yanying Li Yan Zhang Shuang Zhang Yongsheng Wang Yongsheng Wang |
| author_sort | Min Yu |
| collection | DOAJ |
| description | EGFR-TKI is widely used for EGFR-mutant NSCLC patients. Bleeding is reported as a neglected adverse effect induced by EGFR-TKI. Female patients with lung adenocarcinoma have a high frequency of EGFR mutations. This study investigated the effect of EGFR-TKI on the menstrual cycle, especially on bleeding, in women of childbearing age. The underlying mechanism was further investigated in a patient with severe bleeding. We retrospectively investigated the effects on menstrual cycle in premenopausal female NSCLC patients who underwent EGFR-TKI treatment during 2013 to 2019. Menstrual changes including cycle disorders and prolonged bleeding were investigated via questionnaire survey. EGFR signaling, ER, PR and tissue factor expression were analyzed in endometrium tissue obtained from a 43-year-old patient who suffered from continuous vaginal bleeding during treatment with erlotinib and osimertinib. Among 42 premenopausal female patients taking EGFR tyrosine kinase inhibitor, 69.05% patients experienced abnormal menstruation. In women with abnormal menstruation, 41.37% had profuse menstruation and 20.69% had irregular menstruation. In most cases, the abnormal vaginal bleeding stopped when suspending EGFR-TKI. The EGFR-TKI induced abnormal vaginal bleeding might be associated with low progesterone level, decreased EGFR activation and tissue factor (TF) expression in endometrial tissues. EGFR-TKI unusually induce abnormal vaginal bleeding in premenopausal female NSCLC patients, which may be attributed to progesterone/EGFR/TF signaling. Megestrol acetate may be an available and effective drug for the uncommon adverse effect. |
| first_indexed | 2024-04-13T21:08:10Z |
| format | Article |
| id | doaj.art-fc4c525a3f434c6c832db77680607bee |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T21:08:10Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fc4c525a3f434c6c832db77680607bee2022-12-22T02:29:54ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-06-011210.3389/fonc.2022.805538805538Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLCMin Yu0Xiaoyu Li1Xiaoyu Li2Xueqian Wu3Weiya Wang4Yanying Li5Yan Zhang6Shuang Zhang7Yongsheng Wang8Yongsheng Wang9Department of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaInstitute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Pathology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaInstitute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, ChinaEGFR-TKI is widely used for EGFR-mutant NSCLC patients. Bleeding is reported as a neglected adverse effect induced by EGFR-TKI. Female patients with lung adenocarcinoma have a high frequency of EGFR mutations. This study investigated the effect of EGFR-TKI on the menstrual cycle, especially on bleeding, in women of childbearing age. The underlying mechanism was further investigated in a patient with severe bleeding. We retrospectively investigated the effects on menstrual cycle in premenopausal female NSCLC patients who underwent EGFR-TKI treatment during 2013 to 2019. Menstrual changes including cycle disorders and prolonged bleeding were investigated via questionnaire survey. EGFR signaling, ER, PR and tissue factor expression were analyzed in endometrium tissue obtained from a 43-year-old patient who suffered from continuous vaginal bleeding during treatment with erlotinib and osimertinib. Among 42 premenopausal female patients taking EGFR tyrosine kinase inhibitor, 69.05% patients experienced abnormal menstruation. In women with abnormal menstruation, 41.37% had profuse menstruation and 20.69% had irregular menstruation. In most cases, the abnormal vaginal bleeding stopped when suspending EGFR-TKI. The EGFR-TKI induced abnormal vaginal bleeding might be associated with low progesterone level, decreased EGFR activation and tissue factor (TF) expression in endometrial tissues. EGFR-TKI unusually induce abnormal vaginal bleeding in premenopausal female NSCLC patients, which may be attributed to progesterone/EGFR/TF signaling. Megestrol acetate may be an available and effective drug for the uncommon adverse effect.https://www.frontiersin.org/articles/10.3389/fonc.2022.805538/fullvaginal bleedingnon-small cell lung cancerEGFR tyrosine kinase inhibitorepidermal growth factor receptorpremenopausal female |
| spellingShingle | Min Yu Xiaoyu Li Xiaoyu Li Xueqian Wu Weiya Wang Yanying Li Yan Zhang Shuang Zhang Yongsheng Wang Yongsheng Wang Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC Frontiers in Oncology vaginal bleeding non-small cell lung cancer EGFR tyrosine kinase inhibitor epidermal growth factor receptor premenopausal female |
| title | Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC |
| title_full | Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC |
| title_fullStr | Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC |
| title_full_unstemmed | Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC |
| title_short | Continuous Vaginal Bleeding Induced By EGFR-TKI in Premenopausal Female Patients With EGFR Mutant NSCLC |
| title_sort | continuous vaginal bleeding induced by egfr tki in premenopausal female patients with egfr mutant nsclc |
| topic | vaginal bleeding non-small cell lung cancer EGFR tyrosine kinase inhibitor epidermal growth factor receptor premenopausal female |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.805538/full |
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