2022 World Conference on Lung Cancer (ePosters)-EP08.02-023. Differentiation Syndrome in a Patient with Non-Small-Cell Lung Cancer Harboring IDH2 Mutation Treated with Enasidenib.

EP08.02-023. Differentiation Syndrome in a Patient with Non-Small-Cell Lung Cancer Harboring IDH2 Mutation Treated with Enasidenib.

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This case report discusses the occurrence of differentiation syndrome (DS) in a patient with non-small-cell lung cancer (NSCLC) harboring an IDH2 mutation who was being treated with enasidenib, an IDH2 inhibitor. DS is a life-threatening condition associated with acute myeloid leukemia (AML) and acute promyelocytic leukemias treated with certain medications. In this case, the patient experienced symptoms such as respiratory difficulty and pulmonary edema, and imaging showed ground glass opacities and pericardial effusion, which are characteristic of DS. Enasidenib was discontinued for the high suspicion of DS, and the patient was treated with intravenous dexamethasone followed by a slow taper. After recovery, the patient was switched to chemo-immunotherapy with carboplatin, pemetrexed, nivolumab, and ipilimumab.<br /><br />IDH1/2 gain-of-function mutations are known to interfere with cellular differentiation and are associated with poor disease outcomes in NSCLC. Enasidenib, which inhibits IDH2, has been approved for use in refractory AML. While previous studies have reported DS in patients with AML treated with enasidenib, this is the first case of DS in an NSCLC patient being treated with enasidenib for targeting IDH2 mutation. The onset of DS in patients receiving enasidenib has been reported to be delayed, with a median time to onset of 48 days.<br /><br />This case highlights the importance of considering DS as a differential diagnosis and the need for early identification and management in patients with solid tumors undergoing targeted therapy with IDH2 inhibitors. Further research is needed to explore the potential anti-tumor activity of IDH2 inhibitors in the treatment of solid tumors.<br /><br />This case report provides valuable insights into the potential side effects and management of DS in NSCLC patients receiving enasidenib as targeted therapy for IDH2 mutation.

Asset Subtitle

Bhoomika Sukhadia

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Speaker Bhoomika Sukhadia

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

differentiation syndrome

NSCLC

IDH2 mutation

enasidenib

acute myeloid leukemia

respiratory difficulty

chemo-immunotherapy

solid tumors

targeted therapy

side effects