2023 World Conference on Lung Cancer (Posters)-P2.09. Risk of Recurrent Interstitial Lung Disease (ILD) from EGFR TKI Rechallenge after Osimertinib Induced ILD

P2.09. Risk of Recurrent Interstitial Lung Disease (ILD) from EGFR TKI Rechallenge after Osimertinib Induced ILD - PDF(Slides)

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This study examined the risk of recurrent interstitial lung disease (ILD) from EGFR TKI rechallenge after osimertinib-induced ILD. Osimertinib is a standard treatment for patients with EGFR mutation positive non-small cell lung cancer (NSCLC), but it can cause ILD. The objective of the study was to review the safety of EGFR TKI rechallenge in this setting.<br /><br />The study included patients with metastatic EGFR mutation positive NSCLC who received osimertinib from November 2017 to November 2022. Patients with grade 2 or above osimertinib-induced ILD were included in the analysis. Patients with other causes of ILD were excluded.<br /><br />Out of 799 patients who received osimertinib, 27 had a history of grade 2 or above osimertinib-related ILD. Among these patients, 14 received EGFR TKI rechallenge after recovering from ILD. Five patients had osimertinib rechallenge, while nine patients received erlotinib treatment. The risk of recurrent ILD was significantly higher with osimertinib rechallenge (80%) compared to erlotinib rechallenge (11%).<br /><br />The study also included figures showing the episodes of ILD and its resolution in patients who underwent rechallenge. The duration from initiation of osimertinib to the occurrence of the second ILD recurrence ranged from 3 to 12 weeks.<br /><br />The study concluded that the risk of recurrent ILD with osimertinib rechallenge is significantly higher than with erlotinib. Therefore, EGFR TKI rechallenge with erlotinib may be considered, while rechallenge with osimertinib should be prohibited in patients with grade 2 or above osimertinib-induced ILD.<br /><br />Overall, this study provides important insights into the safety of EGFR TKI rechallenge in patients with osimertinib-induced ILD and suggests that caution should be exercised when considering rechallenge with osimertinib.

Asset Subtitle

Molly Li

Meta Tag

Speaker Molly Li

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

interstitial lung disease

EGFR TKI rechallenge

osimertinib-induced ILD

non-small cell lung cancer

metastatic EGFR mutation

grade 2 ILD

erlotinib treatment

recurrent ILD risk

IL episodes resolution

caution in osimertinib rechallenge