Life-threatening pneumonitis after first-line treatment with osimertinib for primary T790M mutated non-small cell lung cancer

Thorac Cancer. 2020 Jul;11(7):2044-2047. doi: 10.1111/1759-7714.13476. Epub 2020 May 6.

Abstract

Epithelial growth factor receptor (EGFR) directed tyrosine kinase inhibitor (TKI) treatment is the standard approach in patients with advanced, EGFR-mutated non-small cell lung cancer (NSCLC). Although benefit/risk ratio is favorable for these TKI and side effects are manageable in the vast majority of patients, severe and even life-threatening side effects have been reported. TKI-induced interstitial lung disease (ILD) has been reported for single cases in modest severity, predominantly in EGFR-TKI pretreated patients. Here, we report a case of successful stabilization of a life-threatening ILD in a de novo T790M mutated NSCLC during first-line treatment with osimertinib. As osimertinib will be used more often in many EGFR-positive NSCLC patients in the future, this potentially life-threatening side effect should receive special attention, especially in first-line treatment.

Keywords: Epithelial growth factor receptor; interstitial lung disease; pneumonitis; side effect; tyrosine kinase inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Acrylamides / adverse effects*
  • Aged
  • Aniline Compounds / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / pathology
  • ErbB Receptors / genetics
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Mutation*
  • Pneumonia / chemically induced
  • Pneumonia / drug therapy*
  • Pneumonia / pathology
  • Protein Kinase Inhibitors / adverse effects*
  • Treatment Outcome

Substances

  • Acrylamides
  • Aniline Compounds
  • Protein Kinase Inhibitors
  • osimertinib
  • EGFR protein, human
  • ErbB Receptors