A41-17 A Case of Afatinib-associated Pneumonitis in a Patient With Egfr-mutant Non-small Cell Lung Cancer
Abstract
Afatinib is a second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that has demonstrated clinical efficacy in patients with non-small cell lung cancer (NSCLC) harboring EGFR mutations. Typical adverse events related to Afatinib are rash or gastrointestinal disturbances; a less common but significantly serious effect is drug-induced pneumonitis.
We present a case of a patient with recently diagnosed metastatic lung adenocarcinoma, who, after initiating treatment with afatinib, develops worsening dyspnea and hypoxemia.
A 67-year-old female with recently diagnosed stage IV EGFR-mutant lung adenocarcinoma presented to the emergency department due to progressive shortness of breath and hypoxemia. One month prior, given her uncommon EGFR mutation, she had been started on Afatinib in the outpatient setting.
The patient was hypoxic on room air, requiring oxygen supplementation with high-flow nasal cannula. Laboratory studies revealed a normal leukocyte count, chest radiograph showed diffuse bilateral interstitial infiltrates. CT pulmonary angiography ruled out pulmonary embolism but demonstrated confluent ground-glass opacities throughout both lungs, which had increased compared to prior outpatient imaging. No significant pleural effusion.
A respiratory viral panel, MRSA nasal swab, Legionella and Streptococcus pneumoniae urine antigens, serum galactomannan, and β-D-glucan were negative. Due to concerns about her immunocompromised state,…
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