Successful Desensitization Treatment with Osimertinib after the Development of Osimertinib-induced Urticaria in a Patient Undergoing Treatment for Non-small Cell Lung Cancer Harboring the &lt;i&gt;EGFR&lt;/i&gt; T790M Mutation

Makimoto, Go; Nishi, Tatsuya; Kawakado, Keita; Nishimura, Tomoka; Tamura, Tomoki; Kudo, Kenichiro; Kuyama, Shoichi

doi:10.2169/internalmedicine.4429-20

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…There are only three published reports of desensitization in patients with osimertinib-related hypersensitivity. Makimoto et al 5 applied a desensitization protocol in one patient with early type urticaria, Hirabayashi et al 6 in one patient with osimertinib-related fever and hepatotoxicity, and Watanabe et al 7 in two patients with osimertinib-related toxic erythema.…”

Section: Discussionmentioning

confidence: 99%

“…For this, a protocol was created in accordance with the protocol used by Makimoto et al to ensure 80 mg of drug intake at the end of the protocol. 5 (Table 1). No dose escalation was made on weekends.…”

Section: Case Reportmentioning

confidence: 99%

“…However, there are very few reports in the literature about desensitization treatment in type 1 allergic reactions associated with osimertinib. 5…”

Section: Introductionmentioning

confidence: 99%

“…3 Osimertinib is associated with many diverse and serious side effects, including skin rash and urticaria. [3][4][5][6][7] However, due to unavailability of any other effective treatment for patients with advanced NSCLC who have the EGFR T790M mutation, it is important to establish an appropriate treatment and management strategy to overcome these side effects in the clinical setting. However, there are very few reports in the literature about desensitization treatment in type 1 allergic reactions associated with osimertinib.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are very few reports in the literature about desensitization treatment in type 1 allergic reactions associated with osimertinib. 5 In this case report, we present a patient with EGFR T790M-positive NSCLC who was successfully desensitized under antihistamine suppression after the onset of osimertinib-induced urticaria.…”

Section: Introductionmentioning

confidence: 99%

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Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Solak

Aksu

Topel

et al. 2022

J Oncol Pharm Pract

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Introduction Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7–13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. Case report A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. Management & outcome With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Discussion Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

“…However, there are very few reports in the literature about desensitization treatment in type 1 allergic reactions associated with osimertinib. 5…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Solak

Aksu

Topel

et al. 2022

J Oncol Pharm Pract

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Two instances of successful oral desensitisation following hypersensitivity reaction in a patient receiving osimertinib: a case report

Bennett,

Rosmalen‐Brinkley,

Johnstone

et al. 2024

Pharmacy Practice and Res

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BackgroundOsimertinib is an irreversible epidermal growth factor receptor (EGFR) tyrosine‐kinase inhibitor (TKI) and an available therapy for patients with non‐small cell lung cancer (NSCLC) that have an EGFR or T790M mutation. It has become the preferred TKI in this patient group as it is superior to first‐generation TKIs; however, osimertinib may be discontinued due to various toxicities or reactions.AimWe report two instances of successful osimertinib desensitisation in a 70‐year‐old woman requiring treatment for NSCLC following two hypersensitivity reactions presenting as angioedema and urticaria.Clinical detailsOsimertinib desensitisation started at 5 mg/day and was gradually increased to 80 mg/day over a period of 30 days.OutcomesThe patient continued osimertinib 80 mg daily for over a year until treatment was withheld for 4 weeks due to thrombocytopenia and diverticulitis. She restarted osimertinib, completing a second desensitisation to a reduced dose of 40 mg daily without serious adverse effect. The patient continues reduced‐dose osimertinib with stable disease.ConclusionThis case report proposes an osimertinib desensitisation strategy useful for select patients experiencing osimertinib‐induced hypersensitivity reactions. It also demonstrates that if there is prolonged disruption to treatment, a second desensitisation can be completed successfully in the same patient so effective treatment in NSCLC may be continued.

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Asfotase Alfa hypersensitivity: an outpatient 8-steps desensitization protocol

et al. 2021

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Successful Desensitization Treatment with Osimertinib after the Development of Osimertinib-induced Urticaria in a Patient Undergoing Treatment for Non-small Cell Lung Cancer Harboring the <i>EGFR</i> T790M Mutation

Cited by 5 publications

References 17 publications

Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Two instances of successful oral desensitisation following hypersensitivity reaction in a patient receiving osimertinib: a case report

Asfotase Alfa hypersensitivity: an outpatient 8-steps desensitization protocol

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