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Vol.59 No.1 contents | Japanese/English |
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- Case Report -
Successful Dose-reduction Therapy for Osimertinib-induced Neutropenia in EGFR-mutant Lung Adenocarcinoma: a Report of Two Cases
Yuki Nakamura1, Osamu Hataji1, Yuta Suzuki1, Tadashi Sakaguchi1, Kentaro Ito1, Yoichi Nishii11Respiratory Center, Matsusaka Municipal Hospital, Japan
Introduction. Osimertinib, a 3rd-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), has good efficacy in the treatment of lung adenocarcinoma harboring EGFR T790M mutation in patients who have previously received TKI treatment. Some cases present severe neutropenia and require dose reduction or discontinuation. Cases. We experienced two cases of advanced lung adenocarcinoma harboring EGFR T790M mutations in patients who had received several chemotherapies and EGFR-TKIs. Case 1 was a 72-year-old man who was a former smoker. Case 2 was an 82-year-old woman who was a non-smoker. The two patients received osimertinib treatment at the standard initial dose as 6th line and 7th line treatments, respectively. In both cases, severe neutropenia occurred as an adverse drug reaction. After several periods of short-term cessation, good clinical efficacy and sustained disease control with reduced-dose osimertinib treatment, without a recurrence of neutropenia. Conclusion. This report indicates that the neutropenia caused by osimertinib may be dose-dependent and that a reduced dose of osimertinib may be clinically effective and show good tolerability, while avoiding the recurrence of severe neutropenia.
key words: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), EGFR T790M, Osimertinib, Neutropenia
Received: February 20, 2018
Accepted: October 28, 2018
JJLC 59 (1): 46-52, 2019
