Clinical Experience using Osimertinib in Patients with Recurrent Malignant Gliomas Containing EGFR Alterations.

Marin Abousaud, Naqeeb M Faroqui, Glenn Lesser, Roy E Strowd, Shakti H Ramkissoon, Madan Kwatra, Kristin S Houston, Fang-Chi Hsu, Annette Carter, Robin Petro, Alisha T DeTroye
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Abstract

Background: EGFR alterations are commonly observed in malignant gliomas (MG). Osimertinib, an irreversible EGFR-tyrosine kinase inhibitor, effectively penetrates the blood brain barrier and achieves therapeutic concentrations in brain tissue.

Materials and methods: This retrospective chart review identified six patients with recurrent MG and EGFR alterations who received osimertinib.

Results: Four patients were assessed for response. One patient had a partial response, two patients achieved stable disease and one was refractory. One patient with an EGFR vIII rearrangement remained on treatment for 236 days and a second patient with an EGFR vIII mutation remained on treatment for 294 days and continued on treatment at the time of analysis. Thrombocytopenia occurred in two patients, one patient developed grade 1 diarrhea and pneumonia, and another patient developed grade 1 mucositis.

Conclusion: Osimertinib had a tolerable safety profile in this heavily pretreated brain tumor population. Osimertinib may benefit select patients with recurrent MG containing EGFR alterations.

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奥西美替尼治疗EGFR改变的复发性恶性胶质瘤的临床经验。
背景:EGFR改变在恶性胶质瘤(MG)中常见。Osimertinib是一种不可逆的EGFR酪氨酸激酶抑制剂,可有效穿透血脑屏障,并在脑组织中达到治疗浓度。材料和方法:这项回顾性图表审查确定了6名接受奥西替尼治疗的复发性MG和EGFR改变患者。结果:对4名患者的反应进行了评估。一名患者出现部分反应,两名患者病情稳定,一名患者难治。一名EGFR vIII重排患者持续治疗236天,第二名EGFR v III突变患者持续治疗294天,并在分析时继续治疗。两名患者出现血小板减少,一名患者出现1级腹泻和肺炎,另一名患者发生1级粘膜炎。结论:奥西美替尼在这个经过大量预处理的脑肿瘤人群中具有可耐受的安全性。奥西美替尼可能有益于复发性MG含EGFR改变的部分患者。
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