Successful Re-administration of Osimertinib in Osimertinib-induced Interstitial Lung Disease with an Organizing Pneumonia Pattern: A Case Report and Literature Review

• Published in: Internal Medicine Vol. 59; no. 6; pp. 823 - 828
• Main Authors: Hotta, Katsuyuki, Makimoto, Go, Ohashi, Kadoaki, Nishii, Kazuya, Miyahara, Nobuaki, Higo, Hisao, Maeda, Yoshinobu, Itano, Junko, Kiura, Katsuyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.03.2020; Japan Science and Technology Agency
• Subjects: Acrylamides - administration & dosage; Acrylamides - adverse effects; Acrylamides - therapeutic use; Adenocarcinoma - drug therapy; Aged; Aniline Compounds - administration & dosage; Aniline Compounds - adverse effects; Aniline Compounds - therapeutic use; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Case Report; Case reports; Chemotherapy; Corticosteroids; drug-induced ILD; Epidermal growth factor receptors; ErbB Receptors - genetics; Female; Humans; Internal medicine; Literature reviews; Lung diseases; Lung Diseases, Interstitial - chemically induced; Lung Neoplasms - drug therapy; Mutants; organizing pneumonia pattern; osimertinib; Pneumonia; Pneumonia - chemically induced; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Protein Kinase Inhibitors - therapeutic use; re-administration; reversed halo sign; Salvage Therapy; drug-induced ILD; organizing pneumonia pattern; re-administration; reversed halo sign; osimertinib
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.3689-19

Osimertinib is the standard therapy for epidermal-growth-factor-receptor (EGFR)-mutant lung cancers. We herein report a case of osimertinib-induced interstitial lung disease (OsiILD) with an organizing pneumonia (OP) pattern and provide a literature-based review. Six months after osimertinib administration, a 75-year-old woman with right pleural carcinomatosis developed ILD with an OP pattern. After salvage chemotherapy, osimertinib with corticosteroid was successfully re-administered. A literature review suggested that 1) OsiILD with an OP pattern was rare but should be recognized, and 2) re-administration of osimertinib in OsiILD was successful in select patients. A criterion that determines whether a patient would benefit from re-administration is warranted.