Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy

CHEN Yongbang; WAN Ning; WANG Bing; PENG Lijun; YANG Ning; XIAO Weibin; XIE Fei; ZHANG Jianping; JI Bo

doi:10.6039/j.issn.1001-0408.2023.05.16

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Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy

更新时间：2023-06-12

- Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy
- ZHONGGUO YAOFANG Vol. 34, Issue 5, Pages: 595-599(2023)
- 作者机构：
  
  1.中国人民解放军南部战区总医院临床药学科，广州;510010
  2.暨南大学药学院，广州　511436
  3.南方医科大学药学院，广州　510515
  4.中国人民解放军南部战区总医院肿瘤科，广州　510010
  5.国家老年疾病临床医学研究中心（解放军总医院）广东分中心，广州　510010
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.05.16
  CLC： R974;R734.2
- Published：15 March 2023，
  
  Received：18 August 2022，
  
  Revised：20 January 2023，
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陈永邦,万宁,王冰等.1例奥希替尼致间质性肺炎患者再用EGFR-TKI治疗的病例分析 ^Δ[J].中国药房,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.
陈永邦,万宁,王冰等.1例奥希替尼致间质性肺炎患者再用EGFR-TKI治疗的病例分析 ^Δ[J].中国药房,2023,34(05):595-599. DOI： 10.6039/j.issn.1001-0408.2023.05.16.

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.

摘要

目的

以奥希替尼为例，探讨患者使用表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）类药物并出现间质性肺炎（IP）后，再次使用EGFR-TKI类药物的方法。

方法

对1例使用奥希替尼后出现IP的患者的IP治疗和再使用EGFR-TKI的方案进行分析，并结合文献报告的病例特点及本病例特征进行文献复习。

结果

该患者因奥希替尼治疗而出现的IP在经过治疗后症状有所缓解，在使用阿美替尼联合激素作为再使用EGFR-TKI的方案后，患者IP的症状亦无加重，但因患者出现疾病进展，停用了阿美替尼。IP发生后需及时处理，应立即停用EGFR-TKI并给予对症治疗。

结论

可采取更换EGFR-TKI、调整EGFR-TKI剂量和联合使用激素等的方式再使用EGFR-TKI靶向治疗。EGFR-TKI致IP的不良反应较少发生，但仍需密切观察。如在改用其他EGFR-TKI后亦需密切监测不良反应与疗效，以便及时调整患者的治疗方案。

Abstract

OBJECTIVE

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

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

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

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.

关键词

奥希替尼间质性肺炎表皮生长因子受体酪氨酸激酶抑制剂不良反应

Keywords

interstitial pneumoniaepidermal growth factor receptor-tyrosine kinase inhibitorsadverse drug reactions

references

中华医学会呼吸病学分会间质性肺疾病学组. 特发性肺纤维化诊断和治疗中国专家共识[J]. 中华结核和呼吸杂志，2016，39（6）：427-432.

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.

胡洁，林丽珠，骆肖群，等. EGFR-TKI不良反应管理专家共识[J]. 中国肺癌杂志，2019，22（2）：57-81.

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.

娄安琦，杜琪，余俊先. 奥希替尼与第一、二代EGFR-TKIs治疗EGFR突变晚期非小细胞肺癌疗效及安全性的Meta分析[J]. 中国临床药学杂志，2020，29（4）：285-289.

张丛惠，崔小康，彭婷婷，等. 奥希替尼治疗EGFR突变的晚期非小细胞肺癌疗效与安全性的Meta分析[J]. 中国药物警戒，2021，18（2）：178-183.

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.

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