Successful Treatment with Ramucirumab Plus Erlotinib following Osimertinib-induced Interstitial Lung Disease

Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are key drugs for patients with EGFR mutation-positive non-small cell lung cancer, and osimertinib is the standard treatment. Although drug-induced interstitial lung disease (ILD) is a remarkable adverse event of EGFR-TKIs, evidence regarding the continuation and re-challenge of EGFR-TKIs after drug-induced severe ILD is lacking. This is the first report of successful switching to ramucirumab plus erlotinib after osimertinib-induced severe ILD in an 81-year-old woman with stage IV lung adenocarcinoma harboring the EGFR L858R mutation in exon 21. These findings suggest that ramucirumab plus erlotinib may be a viable treatment option for osimertinib-induced severe ILD.