Pneumonitis in Patients Receiving Thoracic Radiotherapy and Osimertinib: A Multi-Institutional Study
Leou Ismael Banla, Alice Tzeng, John P. Baillieul, Melin J. Kandekhar, Kelly Fitzgerald, Jaclyn LoPiccolo, Holly A. Poitras, Daniel E. Soto, Julia Rotow, Lisa Singer, Henning Willers, David Kozono, Pasi A. Jänne, Raymond H. Mak, Zofia Piotrowska, Florence K. Keane, Benjamin H. Kann
Abstract
Introduction: Thoracic radiotherapy (TRT) is increasingly used in patients receiving osimertinib for advanced NSCLC, and the risk of pneumonitis is not established. We investigated the risk of pneumonitis and potential risk factors in this population. Methods: We performed a multi-institutional retrospective analysis of patients under active treatment with osimertinib who received TRT between April 2016 and July 2022 at two institutions. Clinical characteristics, including whether osimertinib was held during TRT and pneumonitis incidence and grade (Common Terminology Criteria for Adverse Events version 5.0) were documented. Logistic regression analysis was performed to identify risk factors associated with grade 2 or higher (2+) pneumonitis. Results: = 0.021). Conclusions: Although the overall rate of pneumonitis in patients receiving TRT and osimertinib was relatively low, there was a small risk of severe toxicity. The mean lung dose was associated with an increased risk of developing pneumonitis. These findings inform decision-making for patients and providers.