Related Experiment Video
Updated: Sep 15, 2025
Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma
Published on: March 3, 2023
Potential interactions between traditional Chinese medicine and osimertinib: a Case Report
Min Zhang1, Huiwen Ma2, Wanyi Chen1
1Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China.
Abstract:
Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, played a crucial role in the treatment of EGFR-mutated non-small cell lung cancer. This case firstly reported a case of drug-drug interaction between traditional Chinese medicine (TCM) and osimertinib. A 57-year-old female was diagnosed with stage IV lung adenocarcinoma, who switched from gefitinib to osimertinib after disease progression. However, the carcinoembryonic antigen (CEA) results suggested biochemical recurrence after 48 months. The first osimertinib trough concentration (Ctrough) was 82.1 ng/mL, significantly lower than the FDA-reported 166 ng/mL, with concurrent elevation of the tumor marker carcinoembryonic antigen (CEA). After excluding other possible factors, the decreased osimertinib concentration might be due to the TCM taken by the patient. After adjusting the TCM prescription, the patient's osimertinib Ctrough was stable within the range of 145 and 228 ng/mL without significant adverse reactions and carcinoembryonic antigen levels stabilized. This case underscored the importance of monitoring drug concentrations in patients concurrently using TCM and osimertinib to optimize treatment outcomes and minimize potential drug-drug interactions.
Insights
This case highlights a drug interaction between traditional Chinese medicine (TCM) and osimertinib in lung cancer treatment. Adjusting TCM dosage stabilized osimertinib levels and improved patient outcomes, emphasizing the need for monitoring.
Area of Science:
- Oncology
- Pharmacology
Background:
- Osimertinib is a key treatment for EGFR-mutated non-small cell lung cancer.
- Drug-drug interactions (DDIs) can impact treatment efficacy.
Observation:
- A patient on osimertinib experienced low drug concentrations and tumor marker elevation.
- Concurrent use of traditional Chinese medicine (TCM) was identified as a potential cause for the DDI.
Findings:
- Osimertinib trough concentration was significantly lower than expected (82.1 ng/mL vs. 166 ng/mL).
- Adjusting the TCM prescription normalized osimertinib levels (145–228 ng/mL) and stabilized tumor markers.
Implications:
- This case underscores the potential for DDIs between TCM and targeted cancer therapies like osimertinib.
- Monitoring drug concentrations is crucial for patients using both TCM and osimertinib to ensure optimal treatment and safety.
- Further research into TCM-osimertinib interactions is warranted to guide clinical practice.
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...