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Kaneko et al.                                                                                                                                          Hyperostosis of metastatic adenocarcinoma by gefitinib

           should not be discontinued even if adverse effects of   N,  Kajiki  A.  Flare  phenomenon  following  gefitinib  treatment  of
           other organs might emerge.                            lung adenocarcinoma with bone metastasis.  Tohoku J Exp Med
                                                                 2012;228:163-8.
           Authors’ contributions                             4.   Garfield  D.  Increasing  osteoblastic  lesions  as  a  manifestation  of  a
                                                                 major response to gefitinib. J Thorac Oncol 2006;1:859-60.
           Patient’s  treatment  and  manuscript’s  preparation:  H.   5.   Lind JS, Postmus PE, Smit EF. Osteoblastic bone lesions developing
           Kaneko                                                during treatment  with erlotinib  indicate  major response in patients
           Data acquisition: M. Yoshida                          with non-small cell lung cancer: a brief report.  J Thorac  Oncol
           Study design: K. Shimura, Y. Matsumoto                2010;5:554-7.
           Manuscript’s review: M. Taniwaki, J. Kuroda        6.   Yasuda  Y,  Kawamura  K,  Ichikado  K,  Yoshioka  M.  Alkaline
                                                                 phosphatase  flare  phenomenon  following  epidermal  growth  factor-
           Financial support and sponsorship                     tyrosine  kinase  inhibitor  treatment  of non-small  cell  lung cancer:
           None.                                                 report of a case and case review. Respir Med Case Rep 2014;13:51-3.
                                                              7.   Chao HS, Chang CP, Chiu CH, Chu LS, Chen YM, Tsai CM. Bone
           Conflicts of interest                                 scan flare phenomenon in non-small-cell lung cancer patients treated
                                                                 with gefitinib. Clin Nucl Med 2009;34:346-9.
           There are no conflicts of interest.                8.   Shimazaki C, Uchida R, Nakano S, Namura K, Fuchida S, Okano A,
                                                                 Okamoto M, Inaba T. High serum bone-specific alkaline phosphatase
           Patient consent                                       level  after bortezomib-combined  therapy in refractory  multiple
           All involved patients give their consent forms.       myeloma: possible role of bortezomib on osteoblast differentiation.
                                                                 Leukemia 2005;19:1102-3.
           Ethics approval                                    9.   Normanno  N,  De  Luca A, Aldinucci  D,  Maiello  MR,  Mancino  M,
           Ethics approval was obtained from Institute Review    D’Antonio A, De Fillippi R, Pinto A. Gefitinib inhibits the ability of
           Board for case reports.                               human bone marrow stromal cells to induce osteoclast differentiation:
                                                                 implications for the pathogenesis and treatment of bone metastasis.
                                                                 Endocr Relat Cancer 2005;12:471-82.
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           1.   Coleman  RE,  Whitaker  KB,  Moss  DW,  Mashiter  G,  Fogelman  I,   E, Lantuejoul S, Milleron B, Moro-Sibilot D. Osteoblastic reaction in
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               to treatment. Br J Cancer 1988;58:205-10.         factor receptor tyrosine kinase inhibitors response and prolonged
           2.   Arai Y, Kojima A. A case of lung cancer with alkaline phosphatase   survival. J Thorac Oncol 2010;5:491-6.
               flare  phenomenon  during  gefitinib  therapy.  Nihon Kokyuki  Gakkai   11.  Yoshimoto A, Kasahara K, Kimura H, Kita T, Fujimura M, Nakao
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