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Osimertinib-induced severe bilateral pneumothorax: A case report
He Li1, Xiaojuan Shi, Gang Chen
1Department of Respiration, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Medicine
|January 19, 2024
Summary
Osimertinib, a treatment for EGFR-mutated NSCLC, can cause rare but fatal bilateral pneumothorax. This adverse event, presenting with cough and chest tightness, may be more common in patients with pre-existing respiratory conditions.
Area of Science:
- Oncology
- Pulmonology
- Pharmacology
Background:
- Osimertinib is a third-generation EGFR-TKI standard for advanced NSCLC, particularly with brain metastases.
- It improves progression-free and overall survival in EGFR-mutated NSCLC patients.
- The potential fatality rate of rare adverse events like bilateral pneumothorax requires further investigation.
Observation:
- A 72-year-old male with stage IV NSCLC (EGFR 21L858R mutation) received osimertinib.
- Ten weeks post-treatment initiation, the patient developed severe interstitial lung disease and pneumothorax.
- Initial symptoms included severe cough and chest tightness.
Findings:
- Bilateral pneumothorax was difficult to manage, leading to patient mortality.
- Osimertinib treatment was discontinued, and supportive care with prednisolone was initiated.
- Drug-induced pneumothorax incidence may increase with underlying respiratory conditions.
Implications:
- This case highlights the severe, potentially fatal risk of osimertinib-induced pneumothorax.
- Early recognition of symptoms like cough and chest tightness is crucial for prompt intervention.
- Caution is advised when prescribing osimertinib to NSCLC patients with pre-existing respiratory diseases.
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