Skip to content
2000
Volume 25, Issue 7
  • ISSN: 1568-0096
  • E-ISSN: 1873-5576

Abstract

Introduction

Icotinib and almonertinib are efficacious for non-small cell lung cancer (NSCLC) factor patients with epidermal growth receptor (EGFR)-mutation. Patients who previously used EGFR tyrosine kinase inhibitor (EGFR TKI) may switch to another one due to the adverse events.

Case Presentation

Here, we report a case of a 73-year-old male patient with advanced lung adenocarcinoma in which an EGFR (exon 21 L858R substitution) was found. Icotinib (125mg three times daily) was administered initially. He achieved partial response two months later but developed acute interstitial lung disease (grade 2) with dry cough and chest tightness five months later. Icotinib was discontinued, and treatment with methylprednisolone improved the interstitial lung disease. Chemotherapy with pemetrexed, carboplatin, and bevacizumab was initiated as subsequent therapy. Considering the effectiveness of EGFR-TKIs, we decided cautiously to rechallenge the third-generation TKI almonertinib administration. The patient successfully received almonertinib for almost one year without the recurrence of interstitial lung disease and tumor progression. ILD was an infrequent but often life-threatening reaction associated with icotinib.

Conclusion

This is the first reported case of successful switching from icotinib to another EGFR TKI because of interstitial lung disease associated with icotinib, suggesting that EGFR-TKIs rechallenge because of adverse events rather than progression might provide a significant benefit in patients with EGFR driver positive NSCLC.

© 2025
Loading

Article metrics loading...

/content/journals/ccdt/10.2174/0115680096313868240603090903
2024-07-05
2025-10-11

  • From This Site

    /content/journals/ccdt/10.2174/0115680096313868240603090903
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. AlexanderM. KimS.Y. ChengH. Update 2020: Management of Non-Small Cell Lung Cancer.Lung2020198689790710.1007/s00408‑020‑00407‑5
     [Google Scholar]
  2. MillerM. HannaN. Advances in systemic therapy for non-small cell lung cancer.BMJ2021375236310.1136/bmj.n2363
     [Google Scholar]
  3. Dall’OlioF.G. RizzoA. MollicaV. MassucciM. MaggioI. MassariF. Immortal time bias in the association between toxicity and response for immune checkpoint inhibitors: A meta-analysis.Immunotherapy202113325727010.2217/imt‑2020‑0179
     [Google Scholar]
  4. RizzoA. Identifying optimal first-line treatment for advanced non-small cell lung carcinoma with high PD-L1 expression: a matter of debate.Br. J. Cancer202212781381138210.1038/s41416‑022‑01929‑w
     [Google Scholar]
  5. RizzoA. CusmaiA. GiovannelliF. AcquafreddaS. RinaldiL. MisinoA. MontagnaE.S. UngaroV. LorussoM. PalmiottiG. Impact of proton pump inhibitors and histamine-2-receptor antagonists on non-small cell lung cancer immunotherapy: A systematic review and meta-analysis.Cancers (Basel)2022146140410.3390/cancers14061404
     [Google Scholar]
  6. GuvenD.C. SahinT.K. ErulE. RizzoA. RicciA.D. AksoyS. YalcinS. The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis.Front. Mol. Biosci.20229103912110.3389/fmolb.2022.1039121
     [Google Scholar]
  7. SunQ. HongZ. ZhangC. WangL. HanZ. MaD. Immune checkpoint therapy for solid tumours: clinical dilemmas and future trends.Signal Transduct. Target. Ther.20238132010.1038/s41392‑023‑01522‑4
     [Google Scholar]
  8. ZhangQ. WangR. XuL. Clinical advances in EGFR-TKI combination therapy for EGFR-mutated NSCLC: A narrative review.Transl. Cancer Res.202312123764377810.21037/tcr‑23‑956
     [Google Scholar]
  9. SinghS. SadhukhanS. SonawaneA. 20 years since the approval of first EGFR-TKI, gefitinib: Insight and foresight.Biochim. Biophys. Acta Rev. Cancer20231878618896710.1016/j.bbcan.2023.188967
     [Google Scholar]
  10. BelaniN. LiangK. FradleyM. JuddJ. BorghaeiH. How to Treat EGFR-mutated non–small cell lung cancer.JACC Cardiooncol.20235454254510.1016/j.jaccao.2023.04.005
     [Google Scholar]
  11. ShimodaY. YoshidaT. MiyakoshiJ. TorasawaM. TateishiA. MatsumotoY. MasudaK. ShinnoY. OkumaY. GotoY. HorinouchiH. YamamotoN. OheY. Incidence of serious adverse events caused by tyrosine kinase inhibitor treatment following immune checkpoint inhibitor therapy in advanced NSCLC patients with oncogenic driver alterations.Cancer Immunol. Immunother.20237282613262110.1007/s00262‑023‑03429‑z
     [Google Scholar]
  12. OshimaY. TanimotoT. YujiK. TojoA. EGFR–TKI-associated interstitial pneumonitis in nivolumab-treated patients with non–small cell lung cancer.JAMA Oncol.2018481112111510.1001/jamaoncol.2017.4526
     [Google Scholar]
  13. HirshV. Managing treatment-related adverse events associated with egfr tyrosine kinase inhibitors in advanced non-small-cell lung cancer.Curr. Oncol.201118312613810.3747/co.v18i3.877
     [Google Scholar]
  14. MaZ. PeiJ. ZhangY. LiH. SunD. ZhangY. an, Z. Interstitial pneumonitis associated with EGFR/ALK tyrosine kinase inhibitors used in non–small cell lung cancer: an observational, retrospective, pharmacovigilance study.Expert Opin. Drug Saf.202322323724210.1080/14740338.2022.2110235
     [Google Scholar]
  15. KashizakiF. Safety of readministration of EGFR-TKI after onset of interstitial lung disease in advanced EGFR-Mutated NSCLC: A systematic review and meta-analysis.2024
     [Google Scholar]
  16. SakataY. KawamuraK. ShinguN. HiroshigeS. YasudaY. EguchiY. AnanK. HisanagaJ. NitawakiT. NakanoA. IchikadoK. The effects of switching EGFR‐TKI treatments for non‐small cell lung cancer because of adverse events.Asia Pac. J. Clin. Oncol.2020162e113e11710.1111/ajco.13103
     [Google Scholar]
  17. ZhaoY. ChengB. ChenZ. LiJ. LiangH. ChenY. ZhuF. LiC. XuK. XiongS. LuW. ChenZ. ZhongR. ZhaoS. XieZ. LiuJ. LiangW. HeJ. Toxicity profile of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung cancer: A systematic review and network meta-analysis.Crit. Rev. Oncol. Hematol.202116010330510.1016/j.critrevonc.2021.103305
     [Google Scholar]
  18. SubramanianJ. FernandesA.W. LalibertéF. PavilackM. DerSarkissianM. DuhM.S. The rate of occurrence, healthcare resource use and costs of adverse events among metastatic non-small cell lung cancer patients treated with first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors.Lung Cancer201913813113810.1016/j.lungcan.2019.07.021
     [Google Scholar]
  19. MatsumotoK. NakaoS. HasegawaS. MatsuiT. ShimadaK. MukaiR. TanakaM. UranishiH. NakamuraM. Analysis of drug-induced interstitial lung disease using the Japanese Adverse Drug Event Report database.SAGE Open Med.2020810.1177/2050312120918264
     [Google Scholar]
  20. AntoniouK.M. MargaritopoulosG.A. TomassettiS. BonellaF. CostabelU. PolettiV. Interstitial lung disease.Eur. Respir. Rev.201423131405410.1183/09059180.00009113
     [Google Scholar]
  21. PodolanczukA.J. WongA.W. SaitoS. LaskyJ.A. RyersonC.J. EickelbergO. Update in interstitial lung disease 2020.Am. J. Respir. Crit. Care Med.2021203111343135210.1164/rccm.202103‑0559UP
     [Google Scholar]
  22. KashiwabaraK. SembaH. FujiiS. TsumuraS. Outcome in advanced non-small cell lung cancer patients with successful rechallenge after recovery from epidermal growth factor receptor tyrosine kinase inhibitor-induced interstitial lung disease.Cancer Chemother. Pharmacol.201779470571010.1007/s00280‑017‑3261‑5
     [Google Scholar]
  23. SuzukiH. AoshibaK. YokohoriN. NagaiA. Epidermal growth factor receptor tyrosine kinase inhibition augments a murine model of pulmonary fibrosis.Cancer Res.2003631650545059
     [Google Scholar]
  24. OhmoriT. YamaokaT. AndoK. KusumotoS. KishinoY. ManabeR. SagaraH. Molecular and clinical features of EGFR-TKI-associated lung injury.Int. J. Mol. Sci.202122279210.3390/ijms22020792
     [Google Scholar]
  25. MatsunoO. Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches.Respir. Res.20121313910.1186/1465‑9921‑13‑39
     [Google Scholar]
  26. ZhangY. YangH. ZhaoM. HeJ. Successful treatment of gefitinib-induced acute interstitial pneumonitis with corticosteroid and non-invasive BIPAP-ventilation.J. Thorac. Dis.201243316319
     [Google Scholar]
  27. LongK. SureshK. Pulmonary toxicity of systemic lung cancer therapy.Respirology202025S2Suppl. 2727910.1111/resp.13915
     [Google Scholar]
  28. De SanctisA. TailladeL. VignotS. NovelloS. ConfortiR. SpanoJ.P. ScagliottiG.V. KhayatD. Pulmonary toxicity related to systemic treatment of nonsmall cell lung cancer.Cancer2011117143069308010.1002/cncr.25894
     [Google Scholar]
  29. EnomotoN. Pathological roles of pulmonary cells in acute lung injury: Lessons from clinical practice.Int. J. Mol. Sci.202223231502710.3390/ijms232315027
     [Google Scholar]
  30. Chinese Society of Lung Cancer EGFR-TKI ADR Management Chinese Expert Consensus.Zhongguo Fei Ai Za Zhi20192225781
     [Google Scholar]
  31. WuL. ZhongW. LiA. QiuZ. XieR. ShiH. LuS. Successful treatment of EGFR T790M-mutant non-small cell lung cancer with almonertinib after osimertinib-induced interstitial lung disease: a case report and literature review.Ann. Transl. Med.202191195010.21037/atm‑21‑2823
     [Google Scholar]
  32. ZhangJ. ZhanY. OuyangM. QinY. ZhouC. ChenR. Fatal interstitial lung disease associated with icotinib.J. Thorac. Dis.2014612E267E271
     [Google Scholar]
  33. YangJ.C.H. CamidgeD.R. YangC.T. ZhouJ. GuoR. ChiuC.H. ChangG.C. ShiahH.S. ChenY. WangC.C. BerzD. SuW.C. YangN. WangZ. FangJ. ChenJ. NikolinakosP. LuY. PanH. ManiamA. BazhenovaL. ShiraiK. JahanzebM. WillisM. MasoodN. ChowhanN. HsiaT.C. JianH. LuS. Safety, efficacy, and pharmacokinetics of almonertinib (HS-10296) in pretreated patients with EGFR-mutated advanced NSCLC: A multicenter, open-label, phase 1 trial.J. Thorac. Oncol.202015121907191810.1016/j.jtho.2020.09.001
     [Google Scholar]
/content/journals/ccdt/10.2174/0115680096313868240603090903
Loading
Successful Treatment of Switching EGFR-TKIs for Advanced Lung Adenocarcinoma Due to Interstitial Lung Disease: A Case Report
Curr. Cancer Drug Targets< 25, 865 (2025); https://doi.org/10.2174/0115680096313868240603090903
/content/journals/ccdt/10.2174/0115680096313868240603090903
/content/journals/ccdt/10.2174/0115680096313868240603090903
Loading

Data & Media loading...


  • Article Type:     Case Report
Keyword(s): almonertinib; EGFR-TKIs; icotinib; interstitial lung disease; Lung adenocarcinoma

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test