Osimertinib rechallenge under steroid protection following osimertinib-induced pneumonitis: three case studies.

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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© The Author(s), 2021.

Déclaration de conflit d'intérêts

Conflict of interest statement: Dr Bickert, Dr Kahnert, Dr Götschke, Dr Syunyaeva and Dr Behr: none. Dr Kauffmann-Guerrero reports personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Pfizer, grants and personal fees from Takeda, outside the submitted work. Dr Tufman reports personal fees from Lilly, grants and personal fees from AstraZeneca, personal fees from Takeda, personal fees from Roche, personal fees from Celgene, personal fees from MSD, personal fees from BMS, personal fees from Pfizer, outside the submitted work.