We report a 68-year-old treatment-naïve Asian male patient with metastatic NSCLC harboring an exon 19 deletion mutation of EGFR treated with osimertinib. The patient developed an osimertinib-induced syndrome of inappropriate secretion of antidiuretic hormone (SIADH) after approximately two months of therapy. Following fluid restriction and osimertinib discontinuation, the hyponatremia improved significantly within one week. The patient was started on second-line erlotinib without any signs of hyponatremia after treatment initiation.
There is a lack of published data from randomized prospective clinical trials of osimertinib-induced SIADH in metastatic NSCLC. Further studies to evaluate the potential underlying mechanisms are warranted.
我们报告了一名68岁的初治亚裔男性转移性NSCLC患者,患者携带EGFR19外显子缺失突变,接受奥希替尼治疗。在大约两个月的治疗后,患者出现了奥希替尼诱导的抗利尿激素分泌不当综合征(SIADH)。限液和奥希替尼停药后,低钠血症在1周内明显改善。患者开始使用二线厄洛替尼,治疗开始后没有任何低钠血症的迹象。
目前缺乏奥希替尼诱导的SIADH在转移性NSCLC中的随机前瞻性临床试验的公开数据。需要进一步的研究来评估潜在的潜在机制。