Almonertinib-induced interstitial lung disease

Abstract

Rationale: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have elicited favorable anti-tumor activity in non-small cell lung cancer especially the lung adenocarcinoma. Interstitial lung disease (ILD) is 1 of the fatal side effects of EGFR-TKIs. However, such type of side effect has not been observed in the follow-up during the treatment of the third-generation EGFR-TKI Almonertinib (also called HS-10296). Here, we first report an Almonertinib-induced ILD in an elderly female patient. Patient concerns: A 70-year-old female diagnosed with “ lung adenocarcinoma with intracranial metastasis” harboring a mutation of EGFR 19DEL was administrated with Almonertinib 110 mg orally as the first-line treatment. However, she presented with chest tightness, and shortness of breath, accompanying with paroxysmal dry cough 3 months after the initiation of Almonertinib. Diagnoses: Extensive relevant examinations did not provide conclusive results and the chest computed tomography showed a diffuse ILD in bilateral pulmonary. Interventions: The patient was diagnosed with Almonertinib-induced ILD in the absence of no other potential causes. She discontinued Almonertinib and was treated with oxygen uptaken and methylprednisolone. Outcomes: The whole symptoms were eliminated and the chest computed tomography showed ILD got remission after the prescription of methylprednisolone. Lessons: Almonertinib has potential to cause the rare but severe interstitial lung disease. Clinicians should keep cautious of this when prescribing Almonertinib.

Small Molecule Kinase Inhibitor Drugs (1995–2021): Medical Indication, Pharmacology, and Synthesis

“…Compound 82 was approved by the NMPA in 2020 for second-line treatment of patients with metastatic EGFR-T790M -mutation NSCLC. In rare cases, 82 has potential to cause interstitial lung disease …”

“…In rare cases, 82 has potential to cause interstitial lung disease. 584 Orelabrutinib (83) is a highly selective, irreversible BTK inhibitor developed by InnoCare Pharma (ICP-022) and marketed as Inokai. Compound 83 was approved by the NMPA in 2020 for the treatment of patients with relapsed/ refractory CLL/SLL, and the treatment of patients with relapsed/refractory mantle cell lymphoma.…”

Determination of Osimertinib, Aumolertinib, and Furmonertinib in Human Plasma for Therapeutic Drug Monitoring by UPLC-MS/MS

“…Furthermore, furmonertinib is gradually showing great potential for treating NSCLC [ 11 , 12 , 13 ]. However, adverse events (AEs) and EGFR-TKI resistance can emerge, leading to dose reductions or treatment discontinuation [ 4 , 14 , 15 ]. Plasma drug concentrations are closely associated with drug efficacy and side effects.…”

Successful administration of low-dose almonertinib in a patient with lung adenocarcinoma after osimertinib-induced interstitial lung disease: a case report and literature review

“…The latest phase II clinical trial found that the main adverse reactions of almonertinib were the increase of creatine phosphokinase (7%) and alanine aminotransferase (1.2%), while associated ILD and other serious adverse reactions were extremely rare [ 39 ]. Recently, one literature reported that almonertinib could induce ILD, and the dose used in that literature was 110 mg per day [ 44 ]. The reported patient [ 44 ] was a 70-year-old woman who developed chest tightness, shortness of breath and paroxysmal dry cough after using almonertinib for 3 months.…”

“…Recently, one literature reported that almonertinib could induce ILD, and the dose used in that literature was 110 mg per day [ 44 ]. The reported patient [ 44 ] was a 70-year-old woman who developed chest tightness, shortness of breath and paroxysmal dry cough after using almonertinib for 3 months. Although the tumor was controlled, the partial pressure of oxygen and carbon dioxide were 53.4 and 38.2 mmHg, respectively.…”