Osimertinib-induced cutaneous vasculitis: A case report and review of the literature

Detalhes bibliográficos
Autor(a) principal: Hilário Soldin, Inês
Data de Publicação: 2024
Outros Autores: Barros Alves, Filipa, Cordeiro e Cunha, Joana, Santos, Joana, Estevinho, Fernanda
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: https://doi.org/10.32932/gecp.2023.10.038
Resumo: A 77-year-old patient with a history of stage IVa (cT4N3M1a) lung adenocarcinoma, treated with osimertinib 80 mg/day, developed palpable purpura nine days after starting therapy. Skin biopsy revealed leukocytoclastic vasculitis. A complete clinical and lab workup for systemic involvement was unremarkable. The patient suspended osimertinib and started on methylprednisone 1mg/Kg/day. Skin lesions gradually improved. Four weeks apart, the patient resumed osimertinib 40 mg/day along with prednisolone in a slow taping down scheme until 0.5 mg/Kg/day, without vasculitis relapse. After five months of follow-up, there is a good tolerance and a partial response to treatment. This is the first reported case of cutaneous vasculitis induced by osimertinib described in Portugal and the fourth case reported worldwide. Furthermore, this is the first report in which the osimertinib at a dose of 40 mg daily was rechallenged along with corticosteroid therapy.
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spelling Osimertinib-induced cutaneous vasculitis: A case report and review of the literatureVasculite cutânea associada ao osimertinib: Relato de caso e revisão da literaturaLung cancerOsimertinibLeukocytoclastic VasculitisCancro do pulmãoOsimertinibVasculite leucocitoclásticaA 77-year-old patient with a history of stage IVa (cT4N3M1a) lung adenocarcinoma, treated with osimertinib 80 mg/day, developed palpable purpura nine days after starting therapy. Skin biopsy revealed leukocytoclastic vasculitis. A complete clinical and lab workup for systemic involvement was unremarkable. The patient suspended osimertinib and started on methylprednisone 1mg/Kg/day. Skin lesions gradually improved. Four weeks apart, the patient resumed osimertinib 40 mg/day along with prednisolone in a slow taping down scheme until 0.5 mg/Kg/day, without vasculitis relapse. After five months of follow-up, there is a good tolerance and a partial response to treatment. This is the first reported case of cutaneous vasculitis induced by osimertinib described in Portugal and the fourth case reported worldwide. Furthermore, this is the first report in which the osimertinib at a dose of 40 mg daily was rechallenged along with corticosteroid therapy.Doente de 77 anos, com adenocarcinoma pulmonar estadio IVa (cT4N3M1a) sob osimertinib 80 mg/dia. Nove dias após o início do tratamento desenvolveu lesões de púrpura palpável. A biopsia cutânea revelou vasculite leucocitoclástica. Uma revisão clínica e um estudo analítico completos permitiram excluir atingimento sistémico. O fármaco foi suspenso e a doente iniciou metilprednisolona 1mg/Kg/dia, com melhoria paulatina das lesões. Ao fim de quatro semanas, reiniciou osimertinib 40 mg/dia e desmame progressivo de prednisolona até 0.5 mg/Kg/dia sem recidiva da vasculite. Boa tolerância ao osimertinib ao fim de 5 meses de seguimento. Na primeira avaliação de resposta ao tratamento apresenta resposta parcial. Trata-se do primeiro caso de vasculite cutânea induzida pelo osimertinib descrito em Portugal e o quarto a nível mundial. É, ainda, o primeiro caso de reintrodução do fármaco em metade da dose, em associação a corticoide.Grupo de Estudos de Cancro do Pulmão (GECP)2024-12-27info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.32932/gecp.2023.10.038https://doi.org/10.32932/gecp.2023.10.038Thoracic Cancer Journal; Vol. 20 No. 1 (2023); 35-39reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPenghttps://thoracjournal.com/index.php/tcj/article/view/25https://thoracjournal.com/index.php/tcj/article/view/25/20Copyright (c) 2024 Author(s) (or their employer(s)) and THORAC 2024info:eu-repo/semantics/openAccessHilário Soldin, InêsBarros Alves, FilipaCordeiro e Cunha, JoanaSantos, JoanaEstevinho, Fernanda2025-01-22T08:57:15Zoai:ojs.thoracjournal.com:article/25Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T19:40:58.999441Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
Vasculite cutânea associada ao osimertinib: Relato de caso e revisão da literatura
title Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
spellingShingle Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
Hilário Soldin, Inês
Lung cancer
Osimertinib
Leukocytoclastic Vasculitis
Cancro do pulmão
Osimertinib
Vasculite leucocitoclástica
title_short Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
title_full Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
title_fullStr Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
title_full_unstemmed Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
title_sort Osimertinib-induced cutaneous vasculitis: A case report and review of the literature
author Hilário Soldin, Inês
author_facet Hilário Soldin, Inês
Barros Alves, Filipa
Cordeiro e Cunha, Joana
Santos, Joana
Estevinho, Fernanda
author_role author
author2 Barros Alves, Filipa
Cordeiro e Cunha, Joana
Santos, Joana
Estevinho, Fernanda
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Hilário Soldin, Inês
Barros Alves, Filipa
Cordeiro e Cunha, Joana
Santos, Joana
Estevinho, Fernanda
dc.subject.por.fl_str_mv Lung cancer
Osimertinib
Leukocytoclastic Vasculitis
Cancro do pulmão
Osimertinib
Vasculite leucocitoclástica
topic Lung cancer
Osimertinib
Leukocytoclastic Vasculitis
Cancro do pulmão
Osimertinib
Vasculite leucocitoclástica
description A 77-year-old patient with a history of stage IVa (cT4N3M1a) lung adenocarcinoma, treated with osimertinib 80 mg/day, developed palpable purpura nine days after starting therapy. Skin biopsy revealed leukocytoclastic vasculitis. A complete clinical and lab workup for systemic involvement was unremarkable. The patient suspended osimertinib and started on methylprednisone 1mg/Kg/day. Skin lesions gradually improved. Four weeks apart, the patient resumed osimertinib 40 mg/day along with prednisolone in a slow taping down scheme until 0.5 mg/Kg/day, without vasculitis relapse. After five months of follow-up, there is a good tolerance and a partial response to treatment. This is the first reported case of cutaneous vasculitis induced by osimertinib described in Portugal and the fourth case reported worldwide. Furthermore, this is the first report in which the osimertinib at a dose of 40 mg daily was rechallenged along with corticosteroid therapy.
publishDate 2024
dc.date.none.fl_str_mv 2024-12-27
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://doi.org/10.32932/gecp.2023.10.038
https://doi.org/10.32932/gecp.2023.10.038
url https://doi.org/10.32932/gecp.2023.10.038
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://thoracjournal.com/index.php/tcj/article/view/25
https://thoracjournal.com/index.php/tcj/article/view/25/20
dc.rights.driver.fl_str_mv Copyright (c) 2024 Author(s) (or their employer(s)) and THORAC 2024
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2024 Author(s) (or their employer(s)) and THORAC 2024
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Grupo de Estudos de Cancro do Pulmão (GECP)
publisher.none.fl_str_mv Grupo de Estudos de Cancro do Pulmão (GECP)
dc.source.none.fl_str_mv Thoracic Cancer Journal; Vol. 20 No. 1 (2023); 35-39
reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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