Purpose

This study investigated the safety and efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) re-administration after recovery from EGFR-TKI-induced interstitial lung disease (ILD).

Methods

This multicenter retrospective study collected data from consecutive advanced NSCLC patients who underwent EGFR-TKI re-administration after recovery from EGFR-TKI-induced ILD.

Results

Fifty-eight patients were registered. The grades of initial TKI-induced ILD were grade 1 to 4. TKIs used for re-administration were erlotinib for 15 patients, osimertinib for 15, gefitinib for 14, afatinib for 13 patients, and dacomitinib for 1 patient. ILD recurred in 13 patients (22.4%), comprising 3 patients with grade 1, 6 patients with grade 2, and 4 patients with grade 3. No significant associations were found between ILD recurrence and age, smoking history, performance status, time from initial ILD to TKI re-administration, or concomitant corticosteroid use. However, the incidence of ILD recurrence was high in cases of repeated use of gefitinib or erlotinib or first time use of osimertinib at TKI re-administration. The ILD recurrence rate was lowest in patients treated with first time use of gefitinib (8%) or erlotinib (8%), followed by patients treated with repeated use of osimertinib (9%). The response rate, median progression-free survival by TKI re-administration, and median overall survival were 55%, 9.6 and 84.8 months, respectively.

Conclusion

This study showed that EGFR-TKI re-administration is a feasible and effective treatment for patients who recovered from EGFR-TKI-induced ILD. Our results indicate that re-administration of EGFR-TKI is an important option for long-term prognosis after recovery from EGFR-TKI-induced ILD.

中文翻译：

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EGFR-TKI 诱发间质性肺病 (CS-Lung-005) 后重新给予表皮生长因子受体酪氨酸激酶抑制剂 (EGFR-TKI) 的疗效和安全性

目的

本研究调查了表皮生长因子受体 (EGFR)-酪氨酸激酶抑制剂 (TKI) 在 EGFR-TKI 诱导的间质性肺病 (ILD) 恢复后重新给药的安全性和有效性。

方法

这项多中心回顾性研究收集了连续晚期 NSCLC 患者的数据，这些患者在 EGFR-TKI 诱导的 ILD 恢复后再次接受 EGFR-TKI 治疗。

结果

登记了五十八名患者。初次TKI诱发的ILD分级为1～4级。再次给药的TKI为厄洛替尼15例、奥希替尼15例、吉非替尼14例、阿法替尼13例、达克替尼1例。13 例患者 (22.4%) 出现 ILD 复发，其中 1 级患者 3 例，2 级患者 6 例，3 级患者 4 例。未发现 ILD 复发与年龄、吸烟史、体力状态、初次发病时间之间存在显着相关性。 ILD 重新给予 TKI，或同时使用皮质类固醇。然而，重复使用吉非替尼或厄洛替尼或再次使用 TKI 时首次使用奥希替尼的病例 ILD 复发率较高。首次使用吉非替尼 (8%) 或厄洛替尼 (8%) 治疗的患者 ILD 复发率最低，其次是重复使用奥希替尼 (9%) 治疗的患者。缓解率、再次给予 TKI 的中位无进展生存期和中位总生存期分别为 55%、9.6 和 84.8 个月。

结论

这项研究表明，对于 EGFR-TKI 诱导的间质性肺病 (ILD) 康复患者来说，再次给予 EGFR-TKI 是一种可行且有效的治疗方法。我们的结果表明，重新给予 EGFR-TKI 是 EGFR-TKI 诱导的 ILD 恢复后长期预后的重要选择。