Safety and efficacy of afatinib for the treatment of non-small-cell lung cancer following osimertinib-induced interstitial lung disease: A retrospective study

Nasu, Shingo; Suzuki, Hidekazu; Shiroyama, Takayuki; Tanaka, Ayako; Samejima, Yumiko; Kanai, Tomohiro; Noda, Yoshimi; Morishita, Naoko; Okamoto, Norio; Hirashima, Tomonori

doi:10.1007/s10637-020-00963-w

Cited by 10 publications

(4 citation statements)

References 22 publications

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“…To date, there have been several case reports of successful treatment with erlotinib after gefitinib-induced ILD, and it is known that patients who develop ILD with one EGFR-TKI may be safely treated by switching to another EGFR-TKI [ [16] , [17] , [18] ]. In relation to this, successful treatment with afatinib after osimertinib-induced ILD has been reported, with eight cases reported to date [ 15 , 19 , 20 ]. Taking these reports together with the present case, afatinib may be an important treatment option in patients with osimertinib-induced ILD.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with afatinib following the failure of osimertinib rechallenge with osimertinib-induced interstitial lung disease: A case report

Sato

Sekine

Hagiwara

et al. 2021

Respiratory Medicine Case Reports

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Herein, we report the case of an 84-year-old woman with epidermal growth factor receptor ( EGFR ) mutation exon 19 deletion postoperative recurrent lung adenocarcinoma. Osimertinib was administered as a first-line treatment; however, she was urgently admitted to our hospital due to dyspnea on the 46th day. Chest computed tomography revealed bilateral diffuse ground-glass opacities (GGOs) suggestive of grade 3 osimertinib-induced interstitial lung disease (ILD). After discontinuation of osimertinib in combination with short-term corticosteroid therapy, widespread GGOs were promptly resolved. As the disease gradually deteriorated after discontinuation of osimertinib, we administered osimertinib (80 mg every other day) followed by careful observation. However, bilateral GGOs re-appeared on the 15th day, and the diagnosis of osimertinib-induced ILD was established. After the improvement in ILD following corticosteroid therapy, afatinib was administered as salvage therapy, resulting in desirable control of lung cancer without any relapse of ILD. Our results indicate that afatinib would be a promising alternative treatment option even in patients who develop osimertinib-induced ILD and experience failure of osimertinib rechallenge.

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Section: Discussionmentioning

confidence: 99%

Successful treatment with afatinib following the failure of osimertinib rechallenge with osimertinib-induced interstitial lung disease: A case report

Sato

Sekine

Hagiwara

et al. 2021

Respiratory Medicine Case Reports

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“…One study of five cases treated with EGFR-TKI re-administration reported grade 3 ILD in one case [ 7 ]. Another study of four cases reported no ILD recurrence [ 9 ]. In these case series studies, the overall response rates to EGFR-TKI re-administration were very high (75–100%) [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another study of four cases reported no ILD recurrence [ 9 ]. In these case series studies, the overall response rates to EGFR-TKI re-administration were very high (75–100%) [ 7 – 9 ]. While cases successfully treated with EGFR-TKI re-administration have been reported, the number of cases reported so far have been small and thus the frequency and severity of recurrent EGFR-TKI-induced ILD are not well understood.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Re-administration of Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI) After EGFR-TKI-Induced Interstitial Lung Disease (CS-Lung-005)

Kanaji,

Ichihara,

Tanaka

et al. 2024

Lung

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Purpose This study investigated the safety and efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) re-administration after recovery from EGFR-TKI-induced interstitial lung disease (ILD). Methods This multicenter retrospective study collected data from consecutive advanced NSCLC patients who underwent EGFR-TKI re-administration after recovery from EGFR-TKI-induced ILD. Results Fifty-eight patients were registered. The grades of initial TKI-induced ILD were grade 1 to 4. TKIs used for re-administration were erlotinib for 15 patients, osimertinib for 15, gefitinib for 14, afatinib for 13 patients, and dacomitinib for 1 patient. ILD recurred in 13 patients (22.4%), comprising 3 patients with grade 1, 6 patients with grade 2, and 4 patients with grade 3. No significant associations were found between ILD recurrence and age, smoking history, performance status, time from initial ILD to TKI re-administration, or concomitant corticosteroid use. However, the incidence of ILD recurrence was high in cases of repeated use of gefitinib or erlotinib or first time use of osimertinib at TKI re-administration. The ILD recurrence rate was lowest in patients treated with first time use of gefitinib (8%) or erlotinib (8%), followed by patients treated with repeated use of osimertinib (9%). The response rate, median progression-free survival by TKI re-administration, and median overall survival were 55%, 9.6 and 84.8 months, respectively. Conclusion This study showed that EGFR-TKI re-administration is a feasible and effective treatment for patients who recovered from EGFR-TKI-induced ILD. Our results indicate that re-administration of EGFR-TKI is an important option for long-term prognosis after recovery from EGFR-TKI-induced ILD.

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“…One study of ve cases treated with EGFR-TKI re-administration reported grade 3 ILD in one case [7]. Another study of four cases reported no ILD recurrence [9]. In these case series studies, the overall response rates to EGFR-TKI re-administration were very high (75-100%) [7 − 9].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of re-administration of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) after EGFR-TKI-induced interstitial lung disease (CS-Lung-005)

Kanaji,

Ichihara,

Tanaka

et al. 2023

Preprint

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Purpose This study investigated the safety and efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) re-administration after recovery from EGFR-TKI-induced interstitial lung disease (ILD). Methods This multicenter retrospective study collected data from consecutive advanced NSCLC patients who underwent EGFR-TKI re-administration after recovery from EGFR-TKI-induced ILD. Results Fifty-eight patients were registered. The grades of initial TKI-induced ILD were grade 1 to 4. TKIs used for re-administration were erlotinib for 15 patients, osimertinib for 15, gefitinib for 14, afatinib for 13 patients, and dacomitinib for 1 patient. ILD recurred in 13 patients (22.4%), comprising 3 patients with grade 1, 6 patients with grade 2, and 4 patients with grade 3. No significant associations were found between ILD recurrence and age, smoking history, performance status, time from initial ILD to TKI re-administration, or concomitant corticosteroid use. However, the incidence of ILD recurrence was high in cases of repeated use of gefitinib or erlotinib or first-time use of osimertinib at TKI re-administration. The ILD recurrence rate was lowest in patients treated with first-time use of gefitinib (8%) or erlotinib (8%), followed by patients treated with repeated use of osimertinib (9%). The response rate, median progression-free survival by TKI re-administration, and median overall survival were 55%, 9.6 months, and 84.8 months, respectively. Conclusion This study showed that EGFR-TKI re-administration is a feasible and effective treatment for patients who recovered from EGFR-TKI-induced ILD. Our results indicate that re-administration of EGFR-TKI is an important option for long-term prognosis after recovery from EGFR-TKI-induced ILD.

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Safety and efficacy of afatinib for the treatment of non-small-cell lung cancer following osimertinib-induced interstitial lung disease: A retrospective study

Cited by 10 publications

References 22 publications

Successful treatment with afatinib following the failure of osimertinib rechallenge with osimertinib-induced interstitial lung disease: A case report

Successful treatment with afatinib following the failure of osimertinib rechallenge with osimertinib-induced interstitial lung disease: A case report

Efficacy and Safety of Re-administration of Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI) After EGFR-TKI-Induced Interstitial Lung Disease (CS-Lung-005)

Efficacy and safety of re-administration of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) after EGFR-TKI-induced interstitial lung disease (CS-Lung-005)

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