Therapeutic drug monitoring of osimertinib in non-small cell lung cancer and short bowel syndrome: A case report

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Abstract

Short bowel syndrome (SBS) following extensive intestinal resection is often characterized by impaired absorption of orally administered drugs, including tyrosine kinase inhibitors (TKI). We report the case of a patient with EGFR-mutated non-small cell lung carcinoma treated with 80 mg/day of the TKI osimertinib who achieved partial response of the tumour, but was subsequently subjected to a double-barrelled jejunostomy due to ileus. Due to the development of SBS after the bypass surgery, plasma concentrations of osimertinib were monitored using mass spectrometry. The therapeutic drug monitoring confirmed a malabsorption of osimertinib in the patient (108 ng/mL, which is below the 5th percentile of the expected plasma concentration) and was useful to guide adjustments of TKI dosing in order to achieve adequate blood levels (161 ng/mL after increase of the dose to 120 mg/day) in order to maintain tumour control.

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Longuespée, R., Kunz, J., Fresnais, M., Foerster, K. I., Burhenne, J., Thomas, M., … Haefeli, W. E. (2024). Therapeutic drug monitoring of osimertinib in non-small cell lung cancer and short bowel syndrome: A case report. British Journal of Clinical Pharmacology, 90(1), 344–349. https://doi.org/10.1111/bcp.15924

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