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

Gürgün Tuğçe Vural Solak1, Kurtuluş Aksu1, Musa Topel1

  • 1Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|January 21, 2022
PubMed
Abstract

Insights

Osimertinib desensitization successfully treated a patient with non-small cell lung cancer (NSCLC) who developed urticaria. This allergy management allows continued EGFR-TKI therapy when side effects occur.

Area of Science:

  • Oncology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Osimertinib is a key therapy for EGFR-TKI resistant non-small cell lung cancer (NSCLC) with T790M mutation.
  • Drug-related side effects necessitate treatment cessation in 7-13% of patients.
  • Osimertinib desensitization presents a viable option for managing hypersensitivity reactions.

Observation:

  • A 59-year-old female patient with stage 4 NSCLC developed urticaria 20 hours after her third dose of osimertinib.
  • The patient's condition was diagnosed as osimertinib-induced urticaria, a type 1 allergic reaction.

Findings:

  • A 50-day desensitization protocol was initiated, starting with 0.1 mg/day of osimertinib.
  • The patient successfully reached a maintenance dose of 80 mg/day with concurrent antihistamine use.

Implications:

  • Successful osimertinib desensitization can be a crucial strategy for patients experiencing allergic reactions.
  • This approach enables the continuation of essential EGFR-TKI treatment, improving patient outcomes in NSCLC.
  • Osimertinib desensitization should be considered when treatment discontinuation is due to adverse drug events.
Keywords:
Osimertiniballergycancerdesensitizationdrugimmunotherapyurticaria

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