Abstract：
Although osimertinib is a standard first-line treatment for patients with advanced-stage non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations, the incidence rate of pneumonitis associated with osimertinib is high. However, there are few reports about the safety and efficacy of osimertinib rechallenge after the development of pneumonitis.
We conducted a retrospective multicentre cohort study of consecutive patients who developed pneumonitis associated with osimertinib as a first-line and received osimertinib rechallenge. The primary outcome was the incidence rate of any grade pneumonitis after osimertinib rechallenge. The secondary outcome was treatment efficacy in patients after osimertinib rechallenge.
In total, 33 patients who received osimertinib rechallenge were included. Of them, 26 patients had grade 1, 6 patients had grade 2, and 1 patient had grade 3 initial pneumonitis. The median follow-up period after the osimertinib rechallenge was 16.9 months (interquartile range, 11.1-21.3 months). After the start of osimertinib rechallenge, five patients (15%) experienced mild relapsed pneumonitis. Three of the five patients had similar imaging patterns for initial and relapsed pneumonitis. No significant differences in characteristics were observed between patients with and without relapsed pneumonitis. The median progression-free survival after osimertinib rechallenge was not achieved (95% confidence interval: 10.3 months - not reached).
Osimertinib rechallenge was feasible and effective for patients who developed initial pneumonitis associated with first-line osimertinib therapy. Osimertinib might be considered a treatment option even after the development of mild initial pneumonitis.
We conducted a retrospective multicentre cohort study of consecutive patients who developed pneumonitis associated with osimertinib as a first-line and received osimertinib rechallenge. The primary outcome was the incidence rate of any grade pneumonitis after osimertinib rechallenge. The secondary outcome was treatment efficacy in patients after osimertinib rechallenge.
In total, 33 patients who received osimertinib rechallenge were included. Of them, 26 patients had grade 1, 6 patients had grade 2, and 1 patient had grade 3 initial pneumonitis. The median follow-up period after the osimertinib rechallenge was 16.9 months (interquartile range, 11.1-21.3 months). After the start of osimertinib rechallenge, five patients (15%) experienced mild relapsed pneumonitis. Three of the five patients had similar imaging patterns for initial and relapsed pneumonitis. No significant differences in characteristics were observed between patients with and without relapsed pneumonitis. The median progression-free survival after osimertinib rechallenge was not achieved (95% confidence interval: 10.3 months - not reached).
Osimertinib rechallenge was feasible and effective for patients who developed initial pneumonitis associated with first-line osimertinib therapy. Osimertinib might be considered a treatment option even after the development of mild initial pneumonitis.
摘要：
背景：尽管奥希替尼是表皮生长因子受体（EGFR）突变的晚期非小细胞肺癌（NSCLC）患者的标准一线治疗方案，与奥希替尼相关的肺炎发生率较高.然而,关于发生肺炎后奥希替尼再激发的安全性和有效性的报道很少.
方法：我们进行了一项回顾性多中心队列研究，研究对象是出现与奥希替尼相关的肺炎作为一线治疗并接受奥希替尼再激发的连续患者。主要结局是奥希替尼再激发后任何级别肺炎的发生率。次要结果是奥希替尼再激发后患者的治疗效果。
结果：总计，纳入了33例接受奥希替尼再激发的患者。其中,26例患者为1级，6例患者为2级，1例患者为3级初始肺炎。奥希替尼再激发后的中位随访期为16.9个月（四分位距，11.1-21.3个月）。奥希替尼重新挑战开始后，5例患者(15%)出现轻度复发性肺炎.五名患者中的三名对初次和复发性肺炎具有相似的成像模式。有和没有复发性肺炎的患者之间的特征没有显着差异。奥希替尼再激发后中位无进展生存期未达到（95%置信区间：10.3个月-未达到）。
结论：奥希替尼再激发对于与奥希替尼一线治疗相关的初始肺炎患者是可行和有效的。即使在轻度初始肺炎发生后，奥希替尼也可能被认为是一种治疗选择。
方法：我们进行了一项回顾性多中心队列研究，研究对象是出现与奥希替尼相关的肺炎作为一线治疗并接受奥希替尼再激发的连续患者。主要结局是奥希替尼再激发后任何级别肺炎的发生率。次要结果是奥希替尼再激发后患者的治疗效果。
结果：总计，纳入了33例接受奥希替尼再激发的患者。其中,26例患者为1级，6例患者为2级，1例患者为3级初始肺炎。奥希替尼再激发后的中位随访期为16.9个月（四分位距，11.1-21.3个月）。奥希替尼重新挑战开始后，5例患者(15%)出现轻度复发性肺炎.五名患者中的三名对初次和复发性肺炎具有相似的成像模式。有和没有复发性肺炎的患者之间的特征没有显着差异。奥希替尼再激发后中位无进展生存期未达到（95%置信区间：10.3个月-未达到）。
结论：奥希替尼再激发对于与奥希替尼一线治疗相关的初始肺炎患者是可行和有效的。即使在轻度初始肺炎发生后，奥希替尼也可能被认为是一种治疗选择。
