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1例奥希替尼致间质性肺炎患者再用EGFR-TKI治疗的病例分析
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| 篇名： | 1例奥希替尼致间质性肺炎患者再用EGFR-TKI治疗的病例分析 |
| TITLE： | Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy |
| 摘要： | 目的 以奥希替尼为例，探讨患者使用表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）类药物并出现间质性肺炎（IP）后，再次使用EGFR-TKI类药物的方法。方法对1例使用奥希替尼后出现IP的患者的IP治疗和再使用EGFR-TKI的方案进行分析，并结合文献报告的病例特点及本病例特征进行文献复习。结果该患者因奥希替尼治疗而出现的IP在经过治疗后症状有所缓解，在使用阿美替尼联合激素作为再使用EGFR-TKI的方案后，患者IP的症状亦无加重，但因患者出现疾病进展，停用了阿美替尼。IP发生后需及时处理，应立即停用EGFR-TKI并给予对症治疗。结论可采取更换EGFR-TKI、调整EGFR-TKI剂量和联合使用激素等的方式再使用EGFR-TKI靶向治疗。EGFR-TKI致IP的不良反应较少发生，但仍需密切观察。如在改用其他EGFR-TKI后亦需密切监测不良反应与疗效，以便及时调整患者的治疗方案。 |
| ABSTRACT： | OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time. |
| 期刊： | 2023年第34卷第05期 |
| 作者： | 陈永邦；万宁；王冰；彭丽君；杨宁；萧伟斌；谢菲；张建萍；季波 |
| AUTHORS： | CHEN Yongbang， WAN Ning，WANG Bing，PENG Lijun，YANG Ning，XIAO Weibin，XIE Fei，ZHANG Jianping，JI Bo |
| 关键字： | 奥希替尼；间质性肺炎；表皮生长因子受体酪氨酸激酶抑制剂；不良反应 |
| KEYWORDS： | osimertinib； interstitial pneumonia； epidermal |
| 阅读数： | 269 次 |
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