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奥希替尼诱导的间质性肺疾病后采用类固醇治疗成功再次使用奥希替尼

Successful Osimertinib Rechallenge with Steroid Therapy after Osimertinib-induced Interstitial Lung Disease.

作者信息

Kiriu Tatsunori, Tamura Daisuke, Tachihara Motoko, Sekiya Reina, Hazama Daisuke, Katsurada Masahiro, Nakata Kyosuke, Nagano Tatsuya, Yamamoto Masatsugu, Kamiryo Hiroshi, Kobayashi Kazuyuki, Nishimura Yoshihiro

机构信息

Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.

出版信息

Intern Med. 2018 Jan 1;57(1):91-95. doi: 10.2169/internalmedicine.8947-17. Epub 2017 Oct 16.

Abstract

A 62-year-old male with lung adenocarcinoma harboring an exon 19 deletion in the Epidermal growth factor receptor (EGFR) was treated with EGFR-tyrosine kinase inhibitors (TKIs) and several cytotoxic agents. After administering a fifth-line chemotherapy regimen, a liver biopsy revealed a diagnosis of recurrence with a T790M mutation. After an 82-day course of osimertinib therapy, the patient developed osimertinib-induced interstitial lung disease (ILD). Osimertinib was discontinued, and oral prednisolone was started. The ILD quickly improved, but liver metastases progressed and osimertinib was restarted concurrently with prednisolone. The patient showed neither disease progression nor a recurrence of ILD at 5 months. In situations in which no alternative treatment is available, osimertinib rechallenge should thus be considered as an alternative treatment.

摘要

一名62岁男性,患有肺腺癌,表皮生长因子受体(EGFR)外显子19缺失,接受了EGFR酪氨酸激酶抑制剂(TKIs)和几种细胞毒性药物治疗。在进行第五线化疗方案后,肝脏活检显示诊断为复发且伴有T790M突变。在接受82天的奥希替尼治疗后,患者出现了奥希替尼诱导的间质性肺病(ILD)。停用奥希替尼,并开始口服泼尼松龙。ILD迅速改善,但肝转移进展,于是在使用泼尼松龙的同时重新开始使用奥希替尼。患者在5个月时既未出现疾病进展,也未出现ILD复发。因此,在没有其他替代治疗方法的情况下,应考虑重新使用奥希替尼作为替代治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd1d/5799064/e5746ccac103/1349-7235-57-0091-g001.jpg

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