TY - JOUR T1 - Differential effects of epidermal growth factor receptor inhibitors in a single patient with neuropathic pain JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-239385 VL - 14 IS - 3 SP - e239385 AU - Marte Grønlie Cameron AU - Christian Kersten Y1 - 2021/03/01 UR - http://casereports.bmj.com/content/14/3/e239385.abstract N2 - Neuropathic pain (NP) represents an unmet medical need, where analgesic responses to different epidermal growth factor receptor inhibitors (EGFR-Is) have been described. The human EGFR family of receptors consists of four members (human epidermal growth factor receptor, HER 1–4), signalling via different homodimer and heterodimer combinations. A 52-year-old man was treated with the EGFR-I cetuximab in a trial of severe NP. Pain scores decreased dramatically after blinded cetuximab, but not after placebo. On pain recurrence after the trial, he was prescribed the oral EGFR-Is erlotinib, gefitinib, and lapatinib without relief. However, treatment with the pan-HER-inhibitor afatinib was effective. After 4 years on afatinib, pain control remains excellent with manageable side effects. This is the first reported observation of differential effects of EGFR-Is on NP in the same patient and the first report describing NP relief with afatinib. Further understanding of the underlying pathophysiology could lead to development of EGFR-Is specifically targeting NP. ER -