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Hernandez CL, Lynch DM, Golash AJ, Marquis K, Besz KM, Oxnard G, Rotow J, DeAngelo DJ, Castells M. Anaphylaxis and systemic mastocytosis controlled with KIT inhibitors in a patient with metastatic lung adenocarcinoma. Ann Allergy Asthma Immunol 2023; 131:668-670. [PMID: 37597693 DOI: 10.1016/j.anai.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/21/2023]
Affiliation(s)
- Camellia L Hernandez
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Donna-Marie Lynch
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Abby Jane Golash
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kathleen Marquis
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kylie Marie Besz
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Geoffrey Oxnard
- Department of Medical Oncology, Boston Medical Center, Boston, Massachusetts
| | - Julia Rotow
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daniel J DeAngelo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mariana Castells
- Department of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
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Tamura T, Hata S, Baba T, Koyanagi T, Umeno T, Nishii K, Kuyama S. A case of successful desensitization treatment with tepotinib after tepotinib-induced rash. Respir Med Case Rep 2023; 45:101911. [PMID: 37706029 PMCID: PMC10495622 DOI: 10.1016/j.rmcr.2023.101911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/06/2023] [Accepted: 08/21/2023] [Indexed: 09/15/2023] Open
Abstract
Tepotinib is one of the key drugs for MET exon 14-skipping mutation-positive non-small cell lung cancer (NSCLC). The main adverse event of tepotinib treatment is edema. Rash is a rare adverse event, affecting only 0.7% of patients. We report a case of successful desensitization after skin rash caused by tepotinib. A 61-year-old male was treated with tepotinib 500 mg as second-line therapy for NSCLC with MET exon 14-skipping mutation. Treatment was discontinued on day 12 due to grade 3 erythema throughout the body. After improvement of the skin rash, he was started on 250 mg tepotinib with an oral antihistamine and topical steroid. Treatment was discontinued on day 11 due to skin rash exacerbation. One month of treatment-free follow-up showed skin rash improvement but lung carcinoma growth. Tepotinib desensitization therapy was started at a dose of 12.5 mg and gradually increased to 250 mg/day. The patient has since continued tepotinib treatment without skin rashes. Desensitization therapy may be effective for managing skin rash due to tepotinib.
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Affiliation(s)
- Tomoki Tamura
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
| | - Sakura Hata
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
| | - Takahiro Baba
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
- Department of Internal Medicine, National Hospital Organization, Otake Medical Center, Otake, Japan
| | - Taisaku Koyanagi
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
| | - Takahiro Umeno
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
| | - Kazuya Nishii
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
| | - Shoichi Kuyama
- Department of Respiratory Medicine, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Japan
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Vural Solak GT, Aksu K, Topel M, Çuhadar Erçelebi D, Yeşilkaya S, Demir Ş, Köycü Buhari G, Koca Kalkan İ, Ateş H, Nazik Bahçecioğlu S. Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib. J Oncol Pharm Pract 2022; 28:1454-1457. [DOI: 10.1177/10781552221075809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7–13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. Case report A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. Management & outcome With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Discussion Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.
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Affiliation(s)
- Gürgün Tuğçe Vural Solak
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Kurtuluş Aksu
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Musa Topel
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Dilek Çuhadar Erçelebi
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Selma Yeşilkaya
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Şenay Demir
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Gözde Köycü Buhari
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - İlkay Koca Kalkan
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Hale Ateş
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Sakine Nazik Bahçecioğlu
- Division of Immunology and Allergy, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
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Asfotase Alfa hypersensitivity: an outpatient 8-steps desensitization protocol. Immunol Res 2021; 69:609-611. [PMID: 34528188 DOI: 10.1007/s12026-021-09232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
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