Successful Treatment with Afatinib after Osimertinib-induced Interstitial Lung Disease in a Patient with EGFR-mutant Non-small-cell Lung Cancer

Intern Med. 2021 Feb 15;60(4):591-594. doi: 10.2169/internalmedicine.5435-20. Epub 2020 Sep 30.

Abstract

Osimertinib is the standard treatment for epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer. However, drug-induced interstitial lung disease (ILD) is recognized as a serious adverse event associated with EGFR-tyrosine kinase inhibitors (TKIs). We herein report a 78-year-old woman with stage IV lung adenocarcinoma harboring an EGFR L858R mutation on exon 21 who received rechallenge treatment with afatinib after osimertinib-induced ILD with an organizing pneumonia pattern. This is the first report of successful rechallenge with afatinib after osimertinib-induced ILD. Treatment with other EGFR-TKIs after osimertinib-induced ILD may be an option for subsequent therapy.

Keywords: afatinib; drug-induced ILD; interstitial lung disease; lung cancer; osimertinib.

Publication types

  • Case Reports

MeSH terms

  • Acrylamides
  • Afatinib / therapeutic use
  • Aged
  • Aniline Compounds
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Indoles
  • Lung Diseases, Interstitial* / chemically induced
  • Lung Diseases, Interstitial* / drug therapy
  • Lung Diseases, Interstitial* / genetics
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Mutation
  • Protein Kinase Inhibitors / adverse effects
  • Pyrimidines

Substances

  • Acrylamides
  • Afatinib
  • Aniline Compounds
  • ErbB Receptors
  • Protein Kinase Inhibitors
  • osimertinib
  • Indoles
  • Pyrimidines
  • EGFR protein, human