Osimertinib in a patient with end-stage kidney disease not on hemodialysis

Area of Science:

• Oncology
• Pharmacology
• Nephrology

Background:

• Osimertinib is an effective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for non-small cell lung cancer (NSCLC) with EGFR mutations.
• Primary elimination of Osimertinib is via the fecal route, suggesting no dose adjustment is needed for patients with chronic kidney disease (CKD).
• Limited data exists on Osimertinib's safety in cancer patients with end-stage renal disease (ESRD).

Purpose of the Study:

• To report the safety and efficacy of Osimertinib in a patient with end-stage renal disease (ESRD) and EGFR-mutated lung adenocarcinoma.
• To assess the tolerability of Osimertinib in a patient with ESRD not undergoing hemodialysis (HD).

Main Methods:

• A case report of a 77-year-old woman with EGFR-mutated lung adenocarcinoma and metastatic disease.
• The patient received Osimertinib 80 mg/day for 41 cycles.
• Treatment outcomes, including toxicity and radiological response, were monitored.

Main Results:

• The patient completed 41 cycles of Osimertinib without interruptions.
• No severe toxicities were observed during treatment.
• Complete radiological response was achieved.

Conclusions:

• Osimertinib demonstrates an acceptable safety profile in cancer patients with end-stage renal disease (ESRD) who are not undergoing hemodialysis (HD).
• The fecal elimination route of Osimertinib supports its use without dose modification in ESRD patients.
• Further studies are warranted to confirm these findings in a larger cohort.