Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
DOI:
https://doi.org/10.32932/gecp.2023.10.038Keywords:
Lung cancer, Osimertinib, Leukocytoclastic VasculitisAbstract
A 77-year-old patient with a history of stage IVa (cT4N3M1a) lung adenocarcinoma, treated with osimertinib 80 mg/day, developed palpable purpura nine days after starting therapy. Skin biopsy revealed leukocytoclastic vasculitis. A complete clinical and lab workup for systemic involvement was unremarkable. The patient suspended osimertinib and started on methylprednisone 1mg/Kg/day. Skin lesions gradually improved. Four weeks apart, the patient resumed osimertinib 40 mg/day along with prednisolone in a slow taping down scheme until 0.5 mg/Kg/day, without vasculitis relapse. After five months of follow-up, there is a good tolerance and a partial response to treatment. This is the first reported case of cutaneous vasculitis induced by osimertinib described in Portugal and the fourth case reported worldwide. Furthermore, this is the first report in which the osimertinib at a dose of 40 mg daily was rechallenged along with corticosteroid therapy.Downloads
References
Gen, S., I. Tanaka, M. Morise, J. Koyama, Y. Kodama, A. Matsui, et al., Clinical efficacy of osimertinib in EGFR-mutant non-small cell lung cancer with distant metastasis. BMC Cancer, 2022. 22(1): p. 654.10.1186/s12885-022-09741-8
Lee, C.S., M. Milone, and N. Seetharamu, Osimertinib in EGFR-Mutated Lung Cancer: A Review of the Existing and Emerging Clinical Data. Onco Targets Ther, 2021. 14: p. 4579-4597.10.2147/ott.S227032
Calderon, B. and L. Vazquez, Severe Immune-Related Cutaneous Vasculitis Induced by Osimertinib. Arch Clin Med Case Rep, 2022. 6(4): p. 524-527.10.26502/acmcr.96550508
Su, B.A., W.L. Shen, S.T. Chang, L.Y. Feng, C.J. Wu, and Y.H. Feng, Successful rechallenge with reduced dose of erlotinib in a patient with lung adenocarcinoma who developed erlotinib-associated leukocytoclastic vasculitis: A case report. Oncol Lett, 2012. 3(6): p. 1280-1282.10.3892/ol.2012.647
Iriarte, C., J.H. Young, M.S. Rabin, and N.R. LeBoeuf, Osimertinib-Induced Cutaneous Vasculitis Responsive to Low-Dose Dapsone Without Interruption of Anticancer Therapy: A Case Report and Review of the Literature. JTO Clinical and Research Reports, 2022. 3(11).10.1016/j.jtocrr.2022.100415
Hamada, K., K. Oishi, T. Okita, A. Chikumoto, Y. Ohteru, K. Murakawa, et al., Cutaneous Vasculitis Induced by Osimertinib. J Thorac Oncol, 2019. 14(12): p. 2188- 2189.10.1016/j.jtho.2019.08.2507
AstraZeneca, TAGRISSO Highlights of Prescribing Information. 2022.
Fekete, G.L. and L. Fekete, Cutaneous leukocytoclastic vasculitis associated with erlotinib treatment: A case report and review of the literature. Experimental and Therapeutic Medicine, 2019. 17: p. 1128-1131.10.3892/etm.2018.6988
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