Fatal interstitial lung disease associated with a series of tyrosine kinase inhibitors treatment in a non-small cell lung cancer patient: a case report

Tyrosine kinase inhibitors have significantly improved outcomes for non-small cell lung cancer patient. However, notwithstanding the favorable clinical effects, preclinical toxicity and clinical adverse effects (AEs) inevitably appeared. The impact on safety and degree of toxicity of these promising therapies is not well characterized in patients only with targeted therapy without any chemo- or radiotherapy. We report a case of a non-small cell lung cancer patient who was treated a series of tyrosine kinase inhibitors, including gefitinib, osimertinib, cabozantinib and anlotinib. However, the patient progressively developed into an explosive interstitial pneumonia and died. It is therefore necessary to monitor non-small cell lung cancer patients with tyrosine kinase inhibitors or with pre-existing interstitial lung disease (ILD) very closely as they are at high risk of developing fatal interstitial lung disease.