Successful Osimertinib Rechallenge Without Concomitant Corticosteroids After Osimertinib-induced Pneumonitis

Overview

Journal Respir Med Case Rep

Date 2024 May 7

PMID 38712314

Authors

Taisuke Ito

Kazuo Tsuchiya

Rie Mori

Takuro Akashi

Yoshiyuki Oyama

Masaki Ikeda

Affiliations

Soon will be listed here.

Abstract

A 60-year-old woman was diagnosed with cT4N3M1c stage IVB lung adenocarcinoma with epidermal growth factor receptor mutation of exon19 deletion. After one month of treatment with osimertinib, a cough and diffuse ground glass opacities were observed in the bilateral lung field. Based on the clinical course and the exclusion of other etiologies, osimertinib-induced pneumonitis was diagnosed. The shadows resolved after osimertinib was discontinued. However, brain metastasis and leptomeningeal metastasis developed 20 months later; therefore, osimertinib was re-administered without concomitant corticosteroids. The pulmonary lesion and leptomeningeal metastasis were successfully treated without recurrence of drug-induced pneumonitis for eight months.

References

Kodama H, Wakuda K, Yabe M, Nishioka N, Miyawaki E, Miyawaki T . Retrospective analysis of osimertinib re-challenge after osimertinib-induced interstitial lung disease in patients with EGFR-mutant non-small cell lung carcinoma. Invest New Drugs. 2020; 39(2):571-577. DOI: 10.1007/s10637-020-01005-1. View

Gemma A, Kudoh S, Ando M, Ohe Y, Nakagawa K, Johkoh T . Final safety and efficacy of erlotinib in the phase 4 POLARSTAR surveillance study of 10 708 Japanese patients with non-small-cell lung cancer. Cancer Sci. 2014; 105(12):1584-90. PMC: 4317960. DOI: 10.1111/cas.12550. View

Kashiwabara K, Semba H, Fujii S, Tsumura S . 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. Cancer Chemother Pharmacol. 2017; 79(4):705-710. DOI: 10.1007/s00280-017-3261-5. View

Sato Y, Sumikawa H, Shibaki R, Morimoto T, Sakata Y, Oya Y . Drug-Related Pneumonitis Induced by Osimertinib as First-Line Treatment for Epidermal Growth Factor Receptor Mutation-Positive Non-Small Cell Lung Cancer: A Real-World Setting. Chest. 2022; 162(5):1188-1198. DOI: 10.1016/j.chest.2022.05.035. View

Ohe Y, Imamura F, Nogami N, Okamoto I, Kurata T, Kato T . Osimertinib versus standard-of-care EGFR-TKI as first-line treatment for EGFRm advanced NSCLC: FLAURA Japanese subset. Jpn J Clin Oncol. 2018; 49(1):29-36. PMC: 6322567. DOI: 10.1093/jjco/hyy179. View

Imaji M, Fujimoto D, Sato Y, Sakata Y, Oya Y, Tamiya M . Safety and efficacy of osimertinib rechallenge or continuation after pneumonitis: A multicentre retrospective cohort study. Eur J Cancer. 2022; 179:15-24. DOI: 10.1016/j.ejca.2022.10.029. View

Sato Y, Sekine A, Hagiwara E, Sato M, Yamaya T, Asaoka M . Successful treatment with afatinib following the failure of osimertinib rechallenge with osimertinib-induced interstitial lung disease: A case report. Respir Med Case Rep. 2021; 33:101450. PMC: 8349001. DOI: 10.1016/j.rmcr.2021.101450. View

Noonan S, Sachs P, Camidge D . Transient Asymptomatic Pulmonary Opacities Occurring during Osimertinib Treatment. J Thorac Oncol. 2016; 11(12):2253-2258. PMC: 5353353. DOI: 10.1016/j.jtho.2016.08.144. View

Ando M, Okamoto I, Yamamoto N, Takeda K, Tamura K, Seto T . Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib. J Clin Oncol. 2006; 24(16):2549-56. DOI: 10.1200/JCO.2005.04.9866. View

10.

Kudoh S, Kato H, Nishiwaki Y, Fukuoka M, Nakata K, Ichinose Y . Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med. 2008; 177(12):1348-57. DOI: 10.1164/rccm.200710-1501OC. View

11.

Kiriu T, Tamura D, Tachihara M, Sekiya R, Hazama D, Katsurada M . Successful Osimertinib Rechallenge with Steroid Therapy after Osimertinib-induced Interstitial Lung Disease. Intern Med. 2017; 57(1):91-95. PMC: 5799064. DOI: 10.2169/internalmedicine.8947-17. View

12.

Miyauchi E, Ichinose M, Inoue A . Successful Osimertinib Rechallenge in a Patient with T790M-Mutant Non-Small Cell Lung Cancer after Osimertinib-Induced Interstitial Lung Disease. J Thorac Oncol. 2017; 12(5):e59-e61. DOI: 10.1016/j.jtho.2017.01.027. View

13.

Lee H, Lee H, Sun J, Lee S, Kim Y, Park S . Transient Asymptomatic Pulmonary Opacities During Osimertinib Treatment and its Clinical Implication. J Thorac Oncol. 2018; 13(8):1106-1112. DOI: 10.1016/j.jtho.2018.04.038. View

14.

Nagase M, Ohshima N, Kawashima M, Ohgiya M, Ikeda M, Morio Y . Usefulness of Rapid Desensitization Therapy for Severe Rash Caused by Molecularly Targeted Drugs Used in the Treatment of Non-small-cell Lung Cancer. Intern Med. 2020; 59(24):3201-3205. PMC: 7807110. DOI: 10.2169/internalmedicine.5048-20. View

15.

Akamatsu H, Katakami N, Okamoto I, Kato T, Kim Y, Imamura F . Osimertinib in Japanese patients with EGFR T790M mutation-positive advanced non-small-cell lung cancer: AURA3 trial. Cancer Sci. 2018; 109(6):1930-1938. PMC: 5989837. DOI: 10.1111/cas.13623. View

16.

Nagasaka M, Gadgeel S . Retreatment With Osimertinib Following Pneumonitis. Clin Lung Cancer. 2017; 19(1):e53-e55. DOI: 10.1016/j.cllc.2017.06.017. View

17.

Hirashima T, Satouchi M, Hida T, Nishio M, Kato T, Sakai H . Osimertinib for Japanese patients with T790M-positive advanced non-small-cell lung cancer: A pooled subgroup analysis. Cancer Sci. 2019; 110(9):2884-2893. PMC: 6726692. DOI: 10.1111/cas.14120. View

18.

Nishizawa Y, Yasui M, Yamamori C, Tagami A, Fujimura M, Nakao S . [A case of successful desensitization therapy for isoniazid-induced pneumonitis]. Nihon Kokyuki Gakkai Zasshi. 2004; 42(7):649-54. View