TAPO in first‐line osimertinib therapy and continuation of osimertinib

Abstract Background Osimertinib is associated with a relatively high frequency of drug‐induced interstitial lung disease (D‐ILD), and transient asymptomatic pulmonary opacities (TAPO) have been reported to occur during osimertinib administration. The frequency of TAPO during first‐line treatment and...

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Main Authors: Chihiro Mimura, Kazumi Kaneshiro, Shodai Fujimoto, Ryota Dokuni, Natsuhiko Iwamoto, Kanoko Matsumura, Yukihisa Hatakeyama, Yuko Kono, Motoko Tachihara
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Thoracic Cancer
Subjects:
Online Access:https://doi.org/10.1111/1759-7714.14782
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author Chihiro Mimura
Kazumi Kaneshiro
Shodai Fujimoto
Ryota Dokuni
Natsuhiko Iwamoto
Kanoko Matsumura
Yukihisa Hatakeyama
Yuko Kono
Motoko Tachihara
author_facet Chihiro Mimura
Kazumi Kaneshiro
Shodai Fujimoto
Ryota Dokuni
Natsuhiko Iwamoto
Kanoko Matsumura
Yukihisa Hatakeyama
Yuko Kono
Motoko Tachihara
author_sort Chihiro Mimura
collection DOAJ
description Abstract Background Osimertinib is associated with a relatively high frequency of drug‐induced interstitial lung disease (D‐ILD), and transient asymptomatic pulmonary opacities (TAPO) have been reported to occur during osimertinib administration. The frequency of TAPO during first‐line treatment and the pros and cons of osimertinib continuation is unknown. Methods This was a multicenter, retrospective study. The purpose of this study was to research the frequency of TAPO and to evaluate osimertinib continuation in first‐line therapy. We also evaluated progression‐free survival (PFS) including subgroup analysis. Results From August 2018 to December 2020, 133 patients were enrolled into the study. The median observation period was 23.2 months (0.3–48.3 months). Thirty patients (22.6%) experienced D‐ILD events, including 16 patients (12.1%) with CTCAE grade 1, five patients (3.8%) with grade 2, and nine patients (6.7%) with grade 3 and above D‐ILD. Among the patients with grade 1 D‐ILD, 11 cases (8.3%) of TAPO were observed, and all patients succeeded in osimertinib continuation. The TAPO images were characterized by localized patchy opacities (73%). The median PFS was 22.6 months (95% confidence interval [CI]: 17.8–28.7 months). Patients with TAPO had a significantly longer PFS than patients with non‐TAPO D‐ILD in the multivariate analysis. Conclusions This study showed that grade 1 D‐ILD might include TAPO and that patients with TAPO might have good PFS. We need to consider the possibility of osimertinib continuation when lung opacities appear.
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spelling doaj.art-08f25ea72cab40159dd7263d20e634f62023-02-27T01:36:59ZengWileyThoracic Cancer1759-77061759-77142023-02-0114658459110.1111/1759-7714.14782TAPO in first‐line osimertinib therapy and continuation of osimertinibChihiro Mimura0Kazumi Kaneshiro1Shodai Fujimoto2Ryota Dokuni3Natsuhiko Iwamoto4Kanoko Matsumura5Yukihisa Hatakeyama6Yuko Kono7Motoko Tachihara8Division of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDepartment of Respiratory Medicine Kita‐Harima Medical Center Ono‐City JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDepartment of Respiratory Medicine Hyogo Prefectural Awaji Medical Center Sumoto JapanDepartment of Respiratory Medicine Takatsuki General Hospital Osaka JapanDepartment of Respiratory Medicine Takatsuki General Hospital Osaka JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Kita‐Harima Medical Center Ono‐City JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanAbstract Background Osimertinib is associated with a relatively high frequency of drug‐induced interstitial lung disease (D‐ILD), and transient asymptomatic pulmonary opacities (TAPO) have been reported to occur during osimertinib administration. The frequency of TAPO during first‐line treatment and the pros and cons of osimertinib continuation is unknown. Methods This was a multicenter, retrospective study. The purpose of this study was to research the frequency of TAPO and to evaluate osimertinib continuation in first‐line therapy. We also evaluated progression‐free survival (PFS) including subgroup analysis. Results From August 2018 to December 2020, 133 patients were enrolled into the study. The median observation period was 23.2 months (0.3–48.3 months). Thirty patients (22.6%) experienced D‐ILD events, including 16 patients (12.1%) with CTCAE grade 1, five patients (3.8%) with grade 2, and nine patients (6.7%) with grade 3 and above D‐ILD. Among the patients with grade 1 D‐ILD, 11 cases (8.3%) of TAPO were observed, and all patients succeeded in osimertinib continuation. The TAPO images were characterized by localized patchy opacities (73%). The median PFS was 22.6 months (95% confidence interval [CI]: 17.8–28.7 months). Patients with TAPO had a significantly longer PFS than patients with non‐TAPO D‐ILD in the multivariate analysis. Conclusions This study showed that grade 1 D‐ILD might include TAPO and that patients with TAPO might have good PFS. We need to consider the possibility of osimertinib continuation when lung opacities appear.https://doi.org/10.1111/1759-7714.14782interstitial lung diseaselung cancerNSCLCtransient asymptomatic pulmonary opacity (TAPO)
spellingShingle Chihiro Mimura
Kazumi Kaneshiro
Shodai Fujimoto
Ryota Dokuni
Natsuhiko Iwamoto
Kanoko Matsumura
Yukihisa Hatakeyama
Yuko Kono
Motoko Tachihara
TAPO in first‐line osimertinib therapy and continuation of osimertinib
Thoracic Cancer
interstitial lung disease
lung cancer
NSCLC
transient asymptomatic pulmonary opacity (TAPO)
title TAPO in first‐line osimertinib therapy and continuation of osimertinib
title_full TAPO in first‐line osimertinib therapy and continuation of osimertinib
title_fullStr TAPO in first‐line osimertinib therapy and continuation of osimertinib
title_full_unstemmed TAPO in first‐line osimertinib therapy and continuation of osimertinib
title_short TAPO in first‐line osimertinib therapy and continuation of osimertinib
title_sort tapo in first line osimertinib therapy and continuation of osimertinib
topic interstitial lung disease
lung cancer
NSCLC
transient asymptomatic pulmonary opacity (TAPO)
url https://doi.org/10.1111/1759-7714.14782
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