JTO Clinical and Research Reports (Feb 2024)

Severe Drug-Induced Interstitial Lung Disease After Administration of Osimertinib as Adjuvant Treatment for Resected EGFR-Mutated NSCLC: A Case Report

  • Sho Mitsuya, MD,
  • Masahiro Arai, MD,
  • Kiyoe Kanaoka, MD,
  • Tomoya Funamoto, MD,
  • Hiroyuki Tsuji, MD,
  • Kenjiro Tsuruoka, MD, PhD,
  • Ninso Matsunaga, MD,
  • Takahiko Nakamura, MD,
  • Yosuke Tamura, MD, PhD,
  • Masafumi Imanishi, MD, PhD,
  • Soichiro Ikeda, MD, PhD,
  • Akihisa Imagawa, MD, PhD,
  • Yasuhito Fujisaka, MD, PhD

Journal volume & issue
Vol. 5, no. 2
p. 100631

Abstract

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Osimertinib administration has been approved as an adjuvant treatment after complete surgical resection in patients with EGFR-mutated NSCLC. This article presents the first report of life-threatening postoperative osimertinib-induced interstitial lung disease. An 83-year-old male patient underwent right upper lobectomy (pathologic stage IIA) and osimertinib (80 mg/d) was initiated on postoperative day 75. On day 44 of osimertinib administration, chest computed tomography revealed diffuse ground-glass opacities; accordingly, osimertinib-induced interstitial lung disease was diagnosed. Steroid pulse therapy was initiated using a high-flow nasal cannula to treat dyspnea and hypoxemia, rapidly improving the respiratory status and imaging findings; moreover, the patient’s clinical course was excellent. This case report suggests that the postoperative occurrence of severe osimertinib-induced interstitial lung disease is a crucial factor that must be considered in patient decision-making regarding perioperative treatment.

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