CHEN Yongbang,WAN Ning,WANG Bing,et al.Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy[J].ZHONGGUO YAOFANG,2023,34(05):595-599.
CHEN Yongbang,WAN Ning,WANG Bing,et al.Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy[J].ZHONGGUO YAOFANG,2023,34(05):595-599. DOI: 10.6039/j.issn.1001-0408.2023.05.16.
Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy
To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) in patients with EGFR-TKI-induced interstitial pneumonia (IP), using osimertinib as an example.
METHODS
2
The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case.
RESULTS
2
The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However, almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time, the EGFR-TKI should be discontinued and symptomatic treatment should be given.
CONCLUSIONS
2
EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI, adjusting the dose of EGFR-TKI, and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare, but need to be observed closely. If other EGFR-TKI is used, close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.
KASHIWABARA K , SEMBA H , FUJII S , et al . Outcome in advanced non-small cell lung cancer patients with successful rechallenge after recovery from epidermal growth factor receptor tyrosine kinase inhibitor-induced interstitial lung disease [J ] . Cancer Chemother Pharmacol , 2017 , 79 ( 4 ): 705 - 710 .
MASUDA K , HORINOUCHI H , TANAKA M , et al . Efficacy of anti-PD-1 antibodies in NSCLC patients with an EGFR mutation and high PD-L1 expression [J ] . J Cancer Res Clin Oncol , 2021 , 147 ( 1 ): 245 - 251 .
SAKURADA T , KAKIUCHI S , TAJIMA S , et al . Characteristics of and risk factors for interstitial lung disease induced by chemotherapy for lung cancer [J ] . Ann Pharmacother , 2015 , 49 ( 4 ): 398 - 404 .
MAMESAYA N , KENMOTSU H , KATSUMATA M , et al . Osimertinib-induced interstitial lung disease after treatment with anti-PD1 antibody [J ] . Invest New Drugs , 2017 , 35 ( 1 ): 105 - 107 .
SHAH R R . Tyrosine kinase inhibitor-induced interstitial lung disease:clinical features,diagnostic challenges,and therapeutic dilemmas [J ] . Drug Saf , 2016 , 39 ( 11 ): 1073 - 1091 .
LONG K , SURESH K . Pulmonary toxicity of systemic lung cancer therapy [J ] . Respirology , 2020 , 25 ( Suppl 2 ): 72 - 79 .
XIE X H , WANG X W , WU S M , et al . Fatal toxic effects related to EGFR tyrosine kinase inhibitors based on 53 cohorts with 9 569 participants [J ] . J Thorac Dis , 2020 , 12 ( 8 ): 4057 - 4069 .
OHMORI T , YAMAOKA T , ANDO K , et al . Molecular and clinical features of EGFR-TKI-associated lung injury [J ] . Int J Mol Sci , 2021 , 22 ( 2 ): 792 .
KASHIWABARA K , SEMBA H , FUJII S , et al . Re-administration of chemotherapy in patients with advanced non-small cell lung cancer who recovered from chemotherapy-induced interstitial lung disease [J ] . In Vivo , 2018 , 32 ( 4 ): 851 - 857 .
WU L Q , ZHONG W J , LI A , et al . Successful treatment of EGFR T790M-mutant non-small cell lung cancer with almonertinib after osimertinib-induced interstitial lung disease:a case report and literature review [J ] . Ann Transl Med , 2021 , 9 ( 11 ): 950 .
NISHIMA S , MIYANAGA A , SAITO S , et al . Successful treatment with afatinib after osimertinib-induced interstitial lung disease in a patient with EGFR-mutant non-small-cell lung cancer [J ] . Intern Med , 2021 , 60 ( 4 ): 591 - 594 .
TANI T , NAOKI K , ASAKURA T , et al . Successful treatment of non-small-cell lung cancer with afatinib and a glucocorticoid following gefitinib- and erlotinib-induced interstitial lung disease:a case report [J ] . Mol Clin Oncol , 2016 , 5 ( 4 ): 488 - 490 .
BICKERT C , KAHNERT K , KAUFFMANN-GUERRERO D , et al . Osimertinib rechallenge under steroid protection following osimertinib-induced pneumonitis:three case studies [J ] . Ther Adv Med Oncol , 2021 , 13 : 1758835921 - 1018028 .
BUGÉS C , CARCERENY E , MORAN T , et al . Interstitial lung disease arising from erlotinib treatment in a Caucasian patient [J ] . Clin Lung Cancer , 2015 , 16 ( 2 ): e1 - e3 .
LU S , WANG Q M , ZHANG G J , et al . Abstract CT190:a multicenter,open-label,single-arm,phase Ⅱ study:the third generation EGFR tyrosine kinase inhibitor almonertinib for pretreated EGFR T790M-positive locally advanced or metastatic non-small cell lung cancer (APOLLO) [J ] . Cancer Res , 2020 , 80 ( 16_Supplement ): CT190 .
YANG J C , CAMIDGE D R , YANG C T , et al . Safety,efficacy,and pharmacokinetics of almonertinib (HS-10296) in pretreated patients with EGFR-mutated advanced NSCLC:a multicenter,open-label,phase 1 trial [J ] . J Thorac Oncol , 2020 , 15 ( 12 ): 1907 - 1918 .
Study on the correlation of peak blood concentrations of compound sulfamethoxazole and its metabolites with clinical efficacy and adverse reactions in critically ill patients
Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care
Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients
Adverse reactions of the digestive system caused by glucagon-like peptide-1 receptor agonists
Establishment and clinical application of the method for the determination of blood concentration of apatinib
Related Author
FU Xiangxiang
ZHONG Lili
GU Jiangfan
MEI Mengyu
LI Xinxin
DENG Yang
WANG Min
FU Zhonghua
Related Institution
Dept. of Pharmacy, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University
Hunan Provincial Key Laboratory of Anti-resistance Microbial Drugs, the Third Hospital of Changsha
School of Pharmacy, Hainan Medical University
Cancer Center, Henan Provincial People’s Hospital
Dept. of Pharmacy, Henan Provincial People’s Hospital