Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan.
Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Japan.
Intern Med. 2021 Feb 15;60(4):591-594. doi: 10.2169/internalmedicine.5435-20. Epub 2020 Sep 30.
Osimertinib is the standard treatment for epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer. However, drug-induced interstitial lung disease (ILD) is recognized as a serious adverse event associated with EGFR-tyrosine kinase inhibitors (TKIs). We herein report a 78-year-old woman with stage IV lung adenocarcinoma harboring an EGFR L858R mutation on exon 21 who received rechallenge treatment with afatinib after osimertinib-induced ILD with an organizing pneumonia pattern. This is the first report of successful rechallenge with afatinib after osimertinib-induced ILD. Treatment with other EGFR-TKIs after osimertinib-induced ILD may be an option for subsequent therapy.
奥希替尼是表皮生长因子受体（EGFR）突变型非小细胞肺癌的标准治疗药物。然而，药物诱导的间质性肺病（ILD）已被认为是与 EGFR-酪氨酸激酶抑制剂（TKI）相关的严重不良事件。我们在此报告一例 78 岁女性，患有第四阶段肺腺癌，携带第 21 外显子的 EGFR L858R 突变，在奥希替尼诱导的以机化性肺炎为特征的 ILD 后，接受阿法替尼的重新挑战治疗。这是首例奥希替尼诱导的 ILD 后阿法替尼重新挑战成功的报告。在奥希替尼诱导的 ILD 后使用其他 EGFR-TKIs 进行治疗可能是后续治疗的选择。
