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奥希替尼诱导的间质性肺疾病后,EGFR突变型非小细胞肺癌患者再次使用奥希替尼治疗:一例报告

[Osimertinib Re-challenge for EGFR-mutant NSCLC after 
Osimertinib-induced Interstitial Lung Disease: A Case Report].

作者信息

Gu Junjie, Bai Fan, Song Lan, Wang Yingyi

机构信息

Department of Internal Medicine, 
Peking Union Medical College Hospital, Beijing 100730, China.

Department of Pharmacy,Peking Union Medical College Hospital, Beijing 100730, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2021 Nov 20;24(11):804-807. doi: 10.3779/j.issn.1009-3419.2021.102.39.

Abstract

Osimertinib-induced interstitial lung disease (ILD) is an uncommon, but fatal pulmonary toxicity in some patients. We report a case of a 64-year-old male with stage IV adeno-non-small cell lung cancer (NSCLC) harboring an exon 19 deletion in the epidermal growth factor receptor (EGFR) treated with osimertinib 80 mg/d for first-line targeted therapy. On day 60 after initiating treatment of osimertinib, the patient developed ILD. Osimertinib was discontinued immediately and oral prednisone 60 mg/d was initiated, ILD improved within 13 d. After balancing the risk and benefit, osimertinib was restarted concurrently with prednisone. The patient showed neither disease progression nor a recurrence of ILD for more than 16 months. Based on our case and literature review, retreatment with osimertinib under steroid coverage could be considered as an effective treatment option after careful risk-benefit assessment for patients with EGFR-mutant NSCLC.
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摘要

奥希替尼引起的间质性肺病(ILD)虽不常见,但在部分患者中是致命的肺部毒性反应。我们报告了一例64岁男性IV期腺性非小细胞肺癌(NSCLC)患者,其表皮生长因子受体(EGFR)外显子19缺失,接受80mg/d奥希替尼一线靶向治疗。在开始奥希替尼治疗后的第60天,患者发生了ILD。奥希替尼立即停药,并开始口服泼尼松60mg/d,ILD在13天内得到改善。在权衡风险和获益后,奥希替尼与泼尼松同时重新开始使用。患者在超过16个月的时间里既没有疾病进展,也没有ILD复发。基于我们的病例和文献回顾,对于表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)患者,在仔细评估风险和获益后,在类固醇药物覆盖下重新使用奥希替尼可被视为一种有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c83b/8607285/9ce3739719e8/zgfazz-24-11-804-1.jpg

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