Furmonertinib re-challenge for epidermal growth factor receptor-mutant lung adenocarcinoma after osimertinib-induced interstitial lung disease: A case report.

Abstract

Background: Most non-small cell lung cancer patients have epidermal growth factor receptor (EGFR) activating mutations, such as exon 19 deletion and exon 21 replacement mutations. Osimertinib is a third-generation EGFR-tyrosine kinase inhibitors approved for the treatment of lung cancer patients carrying EGFR activating mutations. Osimertinib-induced interstitial lung disease (ILD) is a rare and potentially fatal pulmonary toxic manifestation of drug therapy. At present, there is no international consensus on the risks and treatment of the osimertinib-induced ILD.

Case summary: We report a case of a 56-year-old woman who was diagnosed with lung adenocarcinoma with lung hilum, mediastinal lymph nodes and brain metastases (T4N3M1c stage IVB). The patient received targeted treatment with osimertinib after radiotherapy and chemotherapy. But she developed ILD after osimertinib treatment. Following active symptomatic treatment and hormone treatment, the lung injury alleviated. The patient was retreated with furmonertinib combined with prednisone and did not experience ILD again. So far, she has survived for 14 months without disease progression.

Conclusion: Retreatment with furmonertinib under prednisone could be considered as an effective therapeutic option after risk-benefit assessment for EGFR-mutant lung adenocarcinoma patients.