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Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report

Although osimertinib is a key drug in the treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation, the safety in hemodialysis patients has not been established. A 76-year-old man was diagnosed with NSCLC with EGFR deletion mutation in exon 19. After trea...

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Autores principales: Tabata, Keisuke, Aoki, Masaya, Miyata, Ryo, Umehara, Tadashi, Harada-Takeda, Aya, Kamimura, Go, Nagata, Toshiyuki, Okizono, Ryuya, Terazono, Hideyuki, Takeda, Yasuo, Suetsugu, Takayuki, Ueda, Kazuhiro, Sato, Masami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626281/
https://www.ncbi.nlm.nih.gov/pubmed/37936662
http://dx.doi.org/10.1159/000531840
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author Tabata, Keisuke
Aoki, Masaya
Miyata, Ryo
Umehara, Tadashi
Harada-Takeda, Aya
Kamimura, Go
Nagata, Toshiyuki
Okizono, Ryuya
Terazono, Hideyuki
Takeda, Yasuo
Suetsugu, Takayuki
Ueda, Kazuhiro
Sato, Masami
author_facet Tabata, Keisuke
Aoki, Masaya
Miyata, Ryo
Umehara, Tadashi
Harada-Takeda, Aya
Kamimura, Go
Nagata, Toshiyuki
Okizono, Ryuya
Terazono, Hideyuki
Takeda, Yasuo
Suetsugu, Takayuki
Ueda, Kazuhiro
Sato, Masami
author_sort Tabata, Keisuke
collection PubMed
description Although osimertinib is a key drug in the treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation, the safety in hemodialysis patients has not been established. A 76-year-old man was diagnosed with NSCLC with EGFR deletion mutation in exon 19. After treatment failure with first- and second-generation EGFR tyrosine kinase inhibitors, a T790M mutation was revealed by liquid biopsy. Hemodialysis was started three times a week because chronic renal failure worsened during treatment. Although the subsequent administration of osimertinib (80 mg daily) resulted in a tumor shrinkage and a gradual increase in the plasma concentration of osimertinib, which resulted in grade 3 general fatigue, reducing the dosage of osimertinib decreased its plasma concentration, leading to an improvement in his adverse event. Subsequently, with by adjusting the dosage while periodically measuring the plasma concentration of osimertinib, a stable therapeutic effect was sustained over the long term with no symptoms. Periodic plasma concentration measurements may be indispensable for successful treatment with osimertinib in hemodialysis patients.
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spelling pubmed-106262812023-11-07 Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report Tabata, Keisuke Aoki, Masaya Miyata, Ryo Umehara, Tadashi Harada-Takeda, Aya Kamimura, Go Nagata, Toshiyuki Okizono, Ryuya Terazono, Hideyuki Takeda, Yasuo Suetsugu, Takayuki Ueda, Kazuhiro Sato, Masami Case Rep Oncol Case Report Although osimertinib is a key drug in the treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation, the safety in hemodialysis patients has not been established. A 76-year-old man was diagnosed with NSCLC with EGFR deletion mutation in exon 19. After treatment failure with first- and second-generation EGFR tyrosine kinase inhibitors, a T790M mutation was revealed by liquid biopsy. Hemodialysis was started three times a week because chronic renal failure worsened during treatment. Although the subsequent administration of osimertinib (80 mg daily) resulted in a tumor shrinkage and a gradual increase in the plasma concentration of osimertinib, which resulted in grade 3 general fatigue, reducing the dosage of osimertinib decreased its plasma concentration, leading to an improvement in his adverse event. Subsequently, with by adjusting the dosage while periodically measuring the plasma concentration of osimertinib, a stable therapeutic effect was sustained over the long term with no symptoms. Periodic plasma concentration measurements may be indispensable for successful treatment with osimertinib in hemodialysis patients. S. Karger AG 2023-08-22 /pmc/articles/PMC10626281/ /pubmed/37936662 http://dx.doi.org/10.1159/000531840 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY) (http://www.karger.com/Services/OpenAccessLicense). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher.
spellingShingle Case Report
Tabata, Keisuke
Aoki, Masaya
Miyata, Ryo
Umehara, Tadashi
Harada-Takeda, Aya
Kamimura, Go
Nagata, Toshiyuki
Okizono, Ryuya
Terazono, Hideyuki
Takeda, Yasuo
Suetsugu, Takayuki
Ueda, Kazuhiro
Sato, Masami
Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title_full Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title_fullStr Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title_full_unstemmed Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title_short Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report
title_sort successful treatment with osimertinib based on therapeutic drug monitoring in a hemodialysis patient with non-small cell lung cancer: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626281/
https://www.ncbi.nlm.nih.gov/pubmed/37936662
http://dx.doi.org/10.1159/000531840
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