EGFR-mutant Non-small Cell Lung Cancer Accompanied by Transient Asymptomatic Pulmonary Opacities Successfully Treated with "Stop-And-Go" Osimertinib

Keigo Kobayashi; Katsuhiko Naoki; Aoi Kuroda; Hiroyuki Yasuda; Ichiro Kawada; Kenzo Soejima; Tomoko Betsuyaku

doi:10.2169/internalmedicine.9609-17

CASE REPORTS

EGFR-mutant Non-small Cell Lung Cancer Accompanied by Transient Asymptomatic Pulmonary Opacities Successfully Treated with "Stop-And-Go" Osimertinib

Keigo Kobayashi, Katsuhiko Naoki, Aoi Kuroda, Hiroyuki Yasuda, Ichiro Kawada, Kenzo Soejima, Tomoko Betsuyaku

Author information

Keigo Kobayashi
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Katsuhiko Naoki
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Cancer Center, Keio University School of Medicine, Japan
Aoi Kuroda
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Hiroyuki Yasuda
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Ichiro Kawada
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Kenzo Soejima
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Clinical and Translational Research Center, Keio University School of Medicine, Japan
Tomoko Betsuyaku
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan

Keywords: non-small cell lung cancer, osimertinib, drug-induced pneumonitis, stop-and-go, EGFR-T790M, transient asymptomatic pulmonary opacities

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 7 Pages 1007-1010

DOI https://doi.org/10.2169/internalmedicine.9609-17

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Abstract

A 69-year-old man with post-operative recurrence of lung adenocarcinoma was treated with multiple chemotherapies, including epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors. A second biopsy revealed an EGFR T790M mutation. As 10th-line chemotherapy, osimertinib was initiated. After 24 weeks, chest computed tomography (CT) revealed asymptomatic ground-glass opacities in both lobes. After four weeks of osimertinib discontinuation, imaging revealed rapid lung cancer progression. Osimertinib was resumed. After 11 weeks, CT revealed decreased lung nodules with no exacerbation of interstitial lung disease. We describe a patient who experienced transient asymptomatic pulmonary opacities during treatment with osimertinib, which was successfully managed by a "stop-and-go" approach.

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