Successful Re-challenge of zongertinib following erythema multiforme-like drug eruption in a patient with HER2-mutant non-small cell lung cancer

Description

Kodai Kawamura, Kaori Kubota, and Kazuya Ichikado report a 2026 case of restarting a targeted cancer drug after a severe skin reaction. Their patient, a fifty-five-year-old woman, had lung cancer driven by a HER2 mutation and was taking zongertinib, a tablet that blocks that growth signal. Two weeks into treatment she developed high fever, widespread target-shaped rash, and mouth sores.

Doctors diagnosed an erythema multiforme-like drug eruption and stopped the drug. A first restart at a lower daily dose failed, bringing the reaction back. A slower step-up plan then worked: dosing every other day first, then daily, let her stay on treatment. Scans later showed major shrinkage of the tumor in her left lung, with no return of the severe rash. The authors argue that careful dose escalation can rescue an effective therapy instead of abandoning it.

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Source: https://europepmc.org/articles/PMC13251473