A Case Report on the Development of Ulcerative Colitis During Osimertinib Therapy for Epidermal Growth Factor Receptor Mutation-Positive Non-Small-Cell Lung Cancer
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Published on: September 30, 2016
Tomoki Tamura1, Misaki Tani1, Hiromichi Ogata1
1Department of Respiratory Medicine NHO Iwakuni Clinical Center Yamaguchi Japan.
Abstract:
Osimertinib, a standard treatment for epidermal growth factor receptor (EGFR)-positive non-small-cell lung cancer, commonly causes manageable diarrhoea. We report osimertinib-induced refractory diarrhoea diagnosed as ulcerative colitis, remitting with mesalazine. A 69-year-old woman with advanced-stage EGFR mutation-positive lung adenocarcinoma developed persistent diarrhoea 3 weeks after starting osimertinib, complicated by anorexia, hypotension, anaemia and renal failure requiring hospitalisation. While anaemia and renal failure improved after osimertinib cessation, diarrhoea persisted. A colonoscopy revealed ulcerative colitis, confirmed by neutrophil and lymphocyte infiltration in the intestinal mucosa, glandular deformation and decreased goblet cells. This case demonstrates that osimertinib-induced ulcerative colitis was successfully treated with mesalazine.
Insights
Osimertinib can cause severe diarrhea, sometimes diagnosed as ulcerative colitis. This case shows mesalazine effectively treated this condition in a patient with EGFR-positive lung cancer.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- Osimertinib is a standard targeted therapy for epidermal growth factor receptor (EGFR)-positive non-small-cell lung cancer (NSCLC).
- Diarrhea is a common side effect of osimertinib, usually manageable.
- Refractory diarrhea can significantly impact patient quality of life and treatment adherence.
Purpose of the Study:
- To report a rare case of osimertinib-induced ulcerative colitis.
- To highlight the diagnostic challenges and successful treatment of this adverse event.
Main Methods:
- A case report of a 69-year-old woman with advanced EGFR-positive lung adenocarcinoma.
- Clinical presentation, diagnostic workup including colonoscopy with biopsy, and treatment response were documented.
- Osimertinib was initiated, leading to severe gastrointestinal symptoms.
Main Results:
- The patient developed refractory diarrhea, anorexia, hypotension, anemia, and renal failure.
- Colonoscopy revealed findings consistent with ulcerative colitis.
- Diarrhea resolved with mesalazine treatment after discontinuation of osimertinib, with improvement in anemia and renal function.
Conclusions:
- Osimertinib can induce ulcerative colitis, presenting as refractory diarrhea.
- Mesalazine is an effective treatment for osimertinib-induced ulcerative colitis.
- Early recognition and appropriate management are crucial for patients experiencing severe gastrointestinal side effects during osimertinib therapy.
