Tan Xinyuan, Chen She, He Liu, Huang Minling, Zhang Xiaoshan
Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine.
Department of Pharmacy, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine.
Anticancer Drugs. 2023 Jul 1;34(6):791-796. doi: 10.1097/CAD.0000000000001443. Epub 2022 Dec 2.
Osimertinib is recommended as the first-line treatment of advanced non-small cell lung cancer (NSCLC) in adults. The most commonly reported adverse events for osimertinib are skin effects, diarrhea, nausea, decreased appetite, fatigue, paronychia, and stomatitis. Severe thrombocytopenia is rarely reported. We present a case of severe thrombocytopenia in a 70-year-old NSCLC patient caused by osimertinib combined with sitagliptin. After remission of thrombocytopenia, the patient was well tolerated with osimertinib re-administration in the absence of sitagliptin. We speculated that declined platelet count might be related to the interaction between osimertinib and sitagliptin by acting with a synergistic effect on platelets. Osimertinib rechallenge can be considered after discontinuing drugs that may contribute to platelet decline if possible, and making a careful assessment of complete blood count and risk of bleeding.
奥希替尼被推荐作为成人晚期非小细胞肺癌（NSCLC）的一线治疗药物。奥希替尼最常报告的不良事件是皮肤反应、腹泻、恶心、食欲减退、疲劳、甲沟炎和口腔炎。严重血小板减少症很少被报告。我们报告一例70岁的NSCLC患者因奥希替尼联合西他列汀导致严重血小板减少症。血小板减少症缓解后，在未使用西他列汀的情况下，患者对重新使用奥希替尼耐受性良好。我们推测血小板计数下降可能与奥希替尼和西他列汀之间的相互作用有关，它们对血小板起协同作用。如果可能，在停用可能导致血小板下降的药物后，并仔细评估全血细胞计数和出血风险后，可以考虑重新使用奥希替尼。
