Severe Drug-Induced Interstitial Lung Disease After Administration of Osimertinib as Adjuvant Treatment for Resected EGFR-Mutated NSCLC: A Case Report.

奥希替尼辅助治疗切除的 EGFR 突变的 NSCLC 后出现严重的药物性间质性肺病 ： 一例病例报告.

• 发表时间: 2024 Feb
• 来源期刊: JTO Clin Res Rep
• DOI: 10.1016/j.jtocrr.2024.100631
• PMID: 38322711
• 文章类型: Case Reports
• 作者列表: Mitsuya S,Arai M,Kanaoka K,Funamoto T,Tsuji H,Tsuruoka K,Matsunaga N,Nakamura T,Tamura Y,Imanishi M,Ikeda S,Imagawa A,Fujisaka Y

关键词: Case report; Drug-induced interstitial lung disease; EGFR tyrosine kinase inhibitor; Osimertinib

Abstract

Osimertinib administration has been approved as an adjuvant treatment after complete surgical resection in patients with EGFR-mutated NSCLC. This article presents the first report of life-threatening postoperative osimertinib-induced interstitial lung disease. An 83-year-old male patient underwent right upper lobectomy (pathologic stage IIA) and osimertinib (80 mg/d) was initiated on postoperative day 75. On day 44 of osimertinib administration, chest computed tomography revealed diffuse ground-glass opacities; accordingly, osimertinib-induced interstitial lung disease was diagnosed. Steroid pulse therapy was initiated using a high-flow nasal cannula to treat dyspnea and hypoxemia, rapidly improving the respiratory status and imaging findings; moreover, the patient\'s clinical course was excellent. This case report suggests that the postoperative occurrence of severe osimertinib-induced interstitial lung disease is a crucial factor that must be considered in patient decision-making regarding perioperative treatment.

摘要

奥希替尼的给药已被批准为EGFR突变的NSCLC患者的完全手术切除后的辅助治疗。本文首次报道了奥希替尼引起的间质性肺病术后危及生命。一名83岁的男性患者接受了右上叶切除术（病理阶段IIA），并在术后第75天开始奥希替尼（80mg/d）。奥希替尼给药第44天，胸部计算机断层扫描显示弥漫性毛玻璃混浊；因此，诊断为奥希替尼诱发的间质性肺病.使用高流量鼻插管开始类固醇脉冲治疗呼吸困难和低氧血症，快速改善呼吸状态和影像学表现；此外，患者的临床病程非常好。该病例报告表明，术后严重奥希替尼诱发的间质性肺病的发生是患者决定围手术期治疗时必须考虑的关键因素。