Efficacy and Safety of Re-administration of Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI) After EGFR-TKI-Induced Interstitial Lung Disease (CS-Lung-005).

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM
Lung Pub Date : 2024-02-01 Epub Date: 2024-01-24 DOI:10.1007/s00408-023-00669-9
Nobuhiro Kanaji, Eiki Ichihara, Takaaki Tanaka, Takashi Ninomiya, Toshiyuki Kozuki, Nobuhisa Ishikawa, Kazuya Nishii, Hiroyasu Shoda, Kakuhiro Yamaguchi, Keita Kawakado, Yuko Toyoda, Masaaki Inoue, Nobuyuki Miyatake, Naoki Watanabe, Takuya Inoue, Hitoshi Mizoguchi, Yuta Komori, Kazuki Kojima, Norimitsu Kadowaki
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引用次数: 0

Abstract

Purpose: This study investigated the safety and efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) re-administration after recovery from EGFR-TKI-induced interstitial lung disease (ILD).

Methods: This multicenter retrospective study collected data from consecutive advanced NSCLC patients who underwent EGFR-TKI re-administration after recovery from EGFR-TKI-induced ILD.

Results: Fifty-eight patients were registered. The grades of initial TKI-induced ILD were grade 1 to 4. TKIs used for re-administration were erlotinib for 15 patients, osimertinib for 15, gefitinib for 14, afatinib for 13 patients, and dacomitinib for 1 patient. ILD recurred in 13 patients (22.4%), comprising 3 patients with grade 1, 6 patients with grade 2, and 4 patients with grade 3. No significant associations were found between ILD recurrence and age, smoking history, performance status, time from initial ILD to TKI re-administration, or concomitant corticosteroid use. However, the incidence of ILD recurrence was high in cases of repeated use of gefitinib or erlotinib or first time use of osimertinib at TKI re-administration. The ILD recurrence rate was lowest in patients treated with first time use of gefitinib (8%) or erlotinib (8%), followed by patients treated with repeated use of osimertinib (9%). The response rate, median progression-free survival by TKI re-administration, and median overall survival were 55%, 9.6 and 84.8 months, respectively.

Conclusion: This study showed that EGFR-TKI re-administration is a feasible and effective treatment for patients who recovered from EGFR-TKI-induced ILD. Our results indicate that re-administration of EGFR-TKI is an important option for long-term prognosis after recovery from EGFR-TKI-induced ILD.

Abstract Image

表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)诱发间质性肺病后再用药的有效性和安全性(CS-Lung-005)。
目的:本研究探讨了表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(TKI)诱导的间质性肺病(ILD)康复后再用药的安全性和有效性:这项多中心回顾性研究收集了EGFR-TKI诱导的间质性肺病康复后接受EGFR-TKI再用药的连续晚期NSCLC患者的数据:结果:共登记了58例患者。重新给药的TKI包括厄洛替尼(15例)、奥西美替尼(15例)、吉非替尼(14例)、阿法替尼(13例)和达科米替尼(1例)。13例患者(22.4%)的ILD复发,其中3例为1级,6例为2级,4例为3级。未发现ILD复发与年龄、吸烟史、表现状态、从初次ILD到再次使用TKI的时间或同时使用皮质类固醇之间存在明显关联。然而,在重复使用吉非替尼或厄洛替尼或首次使用奥希替尼再用TKI时,ILD复发率较高。首次使用吉非替尼(8%)或厄洛替尼(8%)的患者ILD复发率最低,其次是重复使用奥希替尼的患者(9%)。应答率、再次使用TKI的中位无进展生存期和中位总生存期分别为55%、9.6个月和84.8个月:本研究表明,对于EGFR-TKI诱导的ILD康复患者而言,EGFR-TKI再用药是一种可行且有效的治疗方法。我们的研究结果表明,EGFR-TKI诱导的ILD患者康复后,再次使用EGFR-TKI是长期预后的重要选择。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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