Osimertinib: A Novel Dermatologic Adverse Event Profile in Patients with Lung Cancer

摘要

Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) therapy. First‐ and second‐generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third‐generation EGFR‐TKIs. Herein, we describe the dAEs associated with third‐generation EGFR‐TKIs and our clinical experience with osimertinib, a third‐generation EGFR‐TKI approved by the U.S. Food and Drug Administration for the treatment of metastatic, EGFR T790M mutation‐positive non‐small cell lung cancer in patients whose disease has progressed on or after EGFR‐TKI therapy. Case summaries of patients from two of our institutions who received osimertinib and were referred to a dermatologist for dAEs are also presented. Overall, the evidence suggests that osimertinib is associated with less severe and less frequent dAEs than first‐ and second‐generation EGFR‐TKIs and that therefore a different approach is warranted. Finally, we outline dAE management approaches for osimertinib in the context of those typically employed with first‐ and second‐generation EGFR‐TKIs.