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Bickert, Christiane ORCID logoORCID: https://orcid.org/0000-0003-4121-6687; Kahnert, Kathrin; Kauffmann-Guerrero, Diego; Götschke, Jeremias ORCID logoORCID: https://orcid.org/0000-0002-3426-2194; Syunyaeva, Zulfiya; Behr, Jürgen und Tufman, Amanda (2021): Osimertinib rechallenge under steroid protection following osimertinib-induced pneumonitis: three case studies. In: Therapeutic Advances in Medical Oncology, Bd. 13, 17588359211018028: S. 1-7 [PDF, 2MB]

Abstract

Osimertinib is a third-generation tyrosine kinase inhibitor that became the preferred first-line treatment option for metastatic non-small cell lung cancer with sensitizing epidermal growth factor receptor mutations. Drug-induced pneumonitis is known to occur with osimertinib. In case of severe pneumonitis, discontinuation of treatment and therapy with corticosteroids is recommended, and a treatment switch is usually performed. We herein report the treatment course in three patients who were rechallenged with osimertinib under steroid protection following an osimertinib-induced pneumonitis. All our patients were initially re-exposed to a lower dose of osimertinib. Two patients were successfully rechallenged under prednisolone protection. The third patient, who was initially retreated with osimertinib without steroid protection, suffered from a recurrent pneumonitis, and was later rechallenged successfully under steroid protection. Our case series indicates that rechallenge with osimertinib following recovery from osimertinib-induced pneumonitis allows a successful rechallenge in individual cases when alternative treatment options are lacking. Concomitant steroids appear to protect against flares of pneumonitis during rechallenge.

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