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

IF 3 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2024-02-01 DOI:10.1016/j.jtocrr.2024.100631

Sho Mitsuya MD , Masahiro Arai MD , Kiyoe Kanaoka MD , Tomoya Funamoto MD , Hiroyuki Tsuji MD , Kenjiro Tsuruoka MD, PhD , Ninso Matsunaga MD , Takahiko Nakamura MD , Yosuke Tamura MD, PhD , Masafumi Imanishi MD, PhD , Soichiro Ikeda MD, PhD , Akihisa Imagawa MD, PhD , Yasuhito Fujisaka MD, PhD

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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.

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奥希替尼辅助治疗切除的表皮生长因子受体突变非小细胞肺癌后引发的严重药物性间质性肺病：病例报告

奥希替尼已被批准作为表皮生长因子受体突变 NSCLC 患者完全手术切除后的辅助治疗药物。本文首次报道了奥希替尼诱发的危及生命的术后间质性肺病。一名 83 岁的男性患者接受了右上肺叶切除术（病理分期 IIA），并在术后第 75 天开始服用奥希替尼（80 毫克/天）。在服用奥希替尼的第 44 天，胸部计算机断层扫描发现弥漫性磨玻璃不透明；因此诊断为奥希替尼诱发的间质性肺病。为治疗呼吸困难和低氧血症，患者开始使用高流量鼻插管进行类固醇脉冲治疗，呼吸状况和影像学检查结果迅速得到改善；此外，患者的临床疗程非常顺利。本病例报告表明，术后发生严重的奥希替尼诱导的间质性肺病是患者在围手术期治疗决策中必须考虑的关键因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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