Osimertinib is an EGFR inhibitor licensed for the treatment of EGFR-mutant, T790M-positive NSCLC. Previously unreported, frequent transient asymptomatic pulmonary opacities were noted in patients during osimertinib therapy at the University of Colorado.
Computed tomography imaging and clinical notes on patients with NSCLC who had been treated with osimertinib at the University of Colorado were retrospectively reviewed.
Transient asymptomatic pulmonary opacities developed in seven of 20 patients (35%) while they were receiving osimertinib. The radiological patterns seen included ground-glass opacities with or without nodular consolidation. The median time to development of the first lesion was 8.7 weeks (range 1.6–43 weeks), the median time to resolution during continued osimertinib was 6 weeks (range 1–11 weeks).
Transient asymptomatic pulmonary opacities may be a previously unrecognized, benign feature associated with osimertinib therapy that may be mistaken for isolated pulmonary progression or the beginning of more severe pneumonitis. If new-onset pulmonary lesions, especially those associated with ground-glass appearances, are asymptomatic and localized and there is no evidence of disease progression elsewhere, it may be reasonable to continue treatment with osimertinib and monitor the lesions for resolution.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Thoracic Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Pulmonary toxicities of gefitinib in patients with advanced non-small-cell lung cancer: a meta-analysis of randomized controlled trials.Medicine (Baltimore). 2016; 95: e3008
- FDA drug approval summary: gefitinib (ZD1839) (Iressa) tablets.Oncologist. 2003; 8: 303-306
- An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias.Am J Respir Crit Care Med. 2013; 188: 733-748
- Does KRAS mutational status predict chemoresistance in advanced non-small cell lung cancer (NSCLC)?.Lung Cancer. 2014; 83: 383-388
- Interstitial lung disease associated with drug therapy.Br J Cancer. 2004; 91: S18-S23
- AZD9291 in EGFR inhibitor-resistant non-small-cell lung cancer.N Engl J Med. 2015; 372: 1689-1699
- AZD9291-induced acute interstitial lung disease.Chin Med J. 2016; 129: 1507-1508
Published online: September 09, 2016
Accepted: August 28, 2016
Received in revised form: August 25, 2016
Received: August 5, 2016
Disclosure: The authors declare no conflict of interest.
© 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.