Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/6521
Title: Two instances of successful oral desensitisation following hypersensitivity reaction in a patient receiving osimertinib: a case report
Authors: Georgia D. Bennett 
Krysti Rosmalen-Brinkley
Johnstone, Kristoffer 
Messina, Genevieve 
Issue Date: 2024
Publisher: Society of Hospital Pharmacists of Australia
Source: Bennett, G.D., Rosmalen-Brinkley, K., Johnstone, K. and Messina, G. (2024), Two instances of successful oral desensitisation following hypersensitivity reaction in a patient receiving osimertinib: a case report. J Pharm Pract Res, 54: 328-332. https://doi.org/10.1002/jppr.1928
Journal: Journal of Pharmacy Practice & Research
Abstract: Background Osimertinib is an irreversible epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) and an available therapy for patients with non-small cell lung cancer (NSCLC) that have an EGFR or T790M mutation. It has become the preferred TKI in this patient group as it is superior to first-generation TKIs; however, osimertinib may be discontinued due to various toxicities or reactions. Aim We report two instances of successful osimertinib desensitisation in a 70-year-old woman requiring treatment for NSCLC following two hypersensitivity reactions presenting as angioedema and urticaria. Clinical details Osimertinib desensitisation started at 5 mg/day and was gradually increased to 80 mg/day over a period of 30 days. Outcomes The patient continued osimertinib 80 mg daily for over a year until treatment was withheld for 4 weeks due to thrombocytopenia and diverticulitis. She restarted osimertinib, completing a second desensitisation to a reduced dose of 40 mg daily without serious adverse effect. The patient continues reduced-dose osimertinib with stable disease. Conclusion This case report proposes an osimertinib desensitisation strategy useful for select patients experiencing osimertinib-induced hypersensitivity reactions. It also demonstrates that if there is prolonged disruption to treatment, a second desensitisation can be completed successfully in the same patient so effective treatment in NSCLC may be continued.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Georgia D. Bennett, Krysti Rosmalen-Brinkley, Kristoffer Johnstone, Genevieve Messina
DOI: 10.1002/jppr.1928
Keywords: osimertinib;hypersensitivity;desensitisation;non-small cell lung cancer (NSCLC);epidermal growth factor receptor (EGFR);case report
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

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