Severe Psychiatric Symptoms in a Patient With EGFR Exon-20 Insertion Mutation Receiving Mobocertinib: A Case Report

Area of Science:

• Oncology
• Pharmacology

Background:

• Tyrosine kinase inhibitor (TKI) therapy is standard for EGFR-mutated NSCLC.
• EGFR exon-20 insertion mutations confer a worse prognosis.
• Mobocertinib targets EGFR exon-20 insertions with promising early results.

Observation:

• A case report details a 59-year-old woman with metastatic NSCLC and an EGFR exon-20 mutation.
• The patient initially responded well to mobocertinib therapy.
• Severe depression and catatonia emerged approximately 4 months after starting mobocertinib, requiring permanent discontinuation.

Findings:

• Mobocertinib, while effective for EGFR exon-20 NSCLC, can be associated with severe neuropsychiatric adverse events.
• The patient's severe depression and catatonia necessitated stopping mobocertinib treatment.

Implications:

• Neuropsychiatric adverse effects should be closely monitored in patients receiving mobocertinib.
• Dose interruption or discontinuation of mobocertinib should be strongly considered for patients experiencing significant neuropsychiatric side effects.