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Interstitial pneumonitis associated with EGFR/ ALK tyrosine kinase inhibitors used in non–small cell lung cancer: an observational, retrospective, pharmacovigilance study

Zhuo Ma, Jie Pei, Yi Zhang, Yi Zhang, Hao Li, Dan Sun, Yuhui Zhang, Yuhui Zhang, Zhuoling An

2022Expert Opinion on Drug Safety12 citationsDOI

Abstract

BACKGROUND: Epidermal Growth Factor Receptor/ Anaplastic Lymphoma Kinase Tyrosine kinase inhibitors (EGFR/ALK TKIs) may provoke fatal interstitial pneumonitis (IP). The study was conducted to characterize the main characteristics of EGFR/ALK TKI-induced IP and identify factors associated with death. RESEARCH DESIGN AND METHODS: A disproportionality analysis was conducted using Vigibase, the World Health Organization pharmacovigilance database. Clinical features of patients with EGFR/ALK-TKI-related IP were compared between the fatal and non-fatal groups. RESULTS: A total of 3355 EGFR/ALK-TKI-IP events were identified, over half of them from Asia (57.47%) and mostly the aged (63.21%). Osimertinib appeared the strongest IP association. The median time to onset (TTO) was 40 (interquartile range [IQR] 16-84) days. There were significant differences between the fatal and non-fatal groups in terms of reporting year and TKI regimens (P < 0.05). The fatality rate of erlotinib-induced IP was the highest (35.54%). CONCLUSION: Our study showed that EGFR/ALK TKIs were associated with IP that had a high fatality rate and tended to occur earlier in fatal cases. It is necessary to raise awareness of IP surveillance when EGFR/ALK TKIs were administered.

Topics & Concepts

MedicineAnaplastic lymphoma kinaseOsimertinibCeritinibLung cancerErlotinibPneumonitisPharmacovigilanceInternal medicineCrizotinibOncologyEpidermal growth factor receptorPharmacologyCancerAdverse effectLungMalignant pleural effusionLung Cancer Treatments and MutationsInterstitial Lung Diseases and Idiopathic Pulmonary FibrosisCancer Immunotherapy and Biomarkers