Harada Guilherme, Santini Fernando Costa, Canedo Felipe Sales Nogueira Amorim, de Carvalho Oliveira Leandro Jonata, Zuppani Henrique Bortot, De Castro Gilberto
Hospital Sírio Libanês, São Paulo 01525-001, Brazil.
Instituto do Câncer do Estado de São Paulo, São Paulo 01525-001, Brazil.
Ecancermedicalscience. 2019 Oct 21;13:970. doi: 10.3332/ecancer.2019.970. eCollection 2019.
Osimertinib is a first-line treatment option for patients with metastatic non-small cell lung cancer (NSCLC) harbouring EGFR mutations. Pneumonitis is a severe adverse event (AE) related to osimertinib treatment which appears to be more frequent when associated with concurrent or previous anti-PD(L)1 exposure. Data regarding the efficacy and safety of osimertinib rechallenge, especially in the setting of central nervous system (CNS) metastases, are scarce. We herein describe a case of a 53-year-old patient with metastatic EGFR-mutated NSCLC, who developed pneumonitis after osimertinib treatment and was successfully rechallenged with 40 mg daily osimertinib, with CNS response. This dose reduction strategy may be an option for selected patients with brain metastases after tyrosine kinase inhibitors-induced AEs.
奥希替尼是携带EGFR突变的转移性非小细胞肺癌（NSCLC）患者的一线治疗选择。肺炎是与奥希替尼治疗相关的严重不良事件（AE），当与同时或先前使用抗PD（L）1治疗相关时，其出现似乎更频繁。关于奥希替尼再挑战的疗效和安全性的数据，尤其是在中枢神经系统（CNS）转移的情况下，很稀少。我们在此描述了一例53岁转移性EGFR突变NSCLC患者，其在奥希替尼治疗后发生肺炎，并成功以每日40 mg奥希替尼再次挑战，且出现中枢神经系统反应。这种剂量降低策略可能是酪氨酸激酶抑制剂诱导不良事件后选定的脑转移患者的一种选择。
