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Emerging Risk Profile of Lung Cancer Therapy: Diffuse Alveolar Hemorrhage from Osimertinib
Michael J Forte1, Rahul G Sangani1
1West Virginia University, Department of Pulmonary and Critical Care Medicine, PO BOX 9166 1 Medical Center Drive, Morgantown, WV 26506, USA.
Abstract:
Osimertinib is an oral epithelial growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used primarily in the treatment of metastatic non-small cell lung cancer. It is usually well tolerated with less than 5% of patients developing significant pulmonary toxicity from the medication, typically within the first few months after initiation. Previously reported pulmonary adverse reactions include pneumonitis (nonspecific interstitial pneumonia or other forms of acute interstitial process), fleeting asymptomatic infiltrates on imaging, and eosinophilic pneumonia. We present an interesting case of a 65-year-old female with recurrent metastatic adenocarcinoma of the lung, treated with Osimertinib for 4 months, who developed a previously unreported toxicity of diffuse alveolar hemorrhage (DAH) requiring mechanical ventilatory support.
Insights
Osimertinib, an EGFR-TKI for lung cancer, can cause rare pulmonary toxicities. A case report details a patient developing diffuse alveolar hemorrhage (DAH) during Osimertinib treatment.
Area of Science:
- Oncology
- Pulmonology
- Pharmacology
Background:
- Osimertinib is a targeted therapy for metastatic non-small cell lung cancer (NSCLC).
- It inhibits the epidermal growth factor receptor (EGFR) tyrosine kinase.
- Pulmonary toxicity is a known, though uncommon, side effect of EGFR-TKI treatment.
Observation:
- A 65-year-old female with recurrent lung adenocarcinoma was treated with Osimertinib.
- The patient received Osimertinib for 4 months.
- She developed diffuse alveolar hemorrhage (DAH), a severe and previously unreported pulmonary toxicity.
Findings:
- Diffuse alveolar hemorrhage (DAH) is a novel pulmonary adverse event associated with Osimertinib.
- This toxicity required mechanical ventilatory support, indicating significant severity.
- The patient's presentation expands the known spectrum of Osimertinib-induced lung injury.
Implications:
- Clinicians should be aware of DAH as a potential Osimertinib toxicity.
- Early recognition and management of DAH are crucial for patient outcomes.
- Further research is needed to understand the mechanism and incidence of Osimertinib-related DAH.
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