Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series

Paul D. Kruithof; Anita J.W.M. Brouns; Juliette H.R.J. Degens; Lizza E.L. Hendriks; Dennis R. Wong; Robin M.J.M. van Geel; Sander Croes

doi:10.1016/j.cllc.2025.05.012

Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series

Paul D. Kruithof
, Anita J.W.M. Brouns
, Juliette H.R.J. Degens
, Lizza E.L. Hendriks
, Dennis R. Wong
, Robin M.J.M. van Geel
, Sander Croes^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

High exposures of osimertinib are associated with toxicity, and evidence for efficacy at low exposures is scarce: therapeutic drug monitoring can be applied to minimize toxicity while maintaining expected effectiveness.
CYP3A polymorphisms may cause substantial deviations in osimertinib exposure, potentially leading to increased toxicity.
Comedication which induces CYP3A may substantially decrease osimertinib exposure, potentially resulting in subtherapeutic exposures.

Original language	English
Pages (from-to)	e496-e502
Number of pages	7
Journal	Clinical Lung Cancer
Volume	26
Issue number	7
Early online date	1 Jan 2025
DOIs	https://doi.org/10.1016/j.cllc.2025.05.012
Publication status	Published - 1 Nov 2025

Keywords

Case series
Dose frequency adjustment
Non-small cell lung cancer
Osimertinib
Therapeutic Drug Monitoring

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10.1016/j.cllc.2025.05.012Licence: CC BY

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title = "Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series",

abstract = "High exposures of osimertinib are associated with toxicity, and evidence for efficacy at low exposures is scarce: therapeutic drug monitoring can be applied to minimize toxicity while maintaining expected effectiveness. CYP3A polymorphisms may cause substantial deviations in osimertinib exposure, potentially leading to increased toxicity. Comedication which induces CYP3A may substantially decrease osimertinib exposure, potentially resulting in subtherapeutic exposures.",

keywords = "Case series, Dose frequency adjustment, Non-small cell lung cancer, Osimertinib, Therapeutic Drug Monitoring",

author = "Kruithof, \{Paul D.\} and Brouns, \{Anita J.W.M.\} and Degens, \{Juliette H.R.J.\} and Hendriks, \{Lizza E.L.\} and Wong, \{Dennis R.\} and \{van Geel\}, \{Robin M.J.M.\} and Sander Croes",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = nov,

day = "1",

doi = "10.1016/j.cllc.2025.05.012",

language = "English",

volume = "26",

pages = "e496--e502",

journal = "Clinical Lung Cancer",

issn = "1525-7304",

publisher = "Elsevier Inc.",

number = "7",

}

Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series. / Kruithof, Paul D.; Brouns, Anita J.W.M.; Degens, Juliette H.R.J. et al.
In: Clinical Lung Cancer, Vol. 26, No. 7, 01.11.2025, p. e496-e502.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer

T2 - A Case series

AU - Kruithof, Paul D.

AU - Brouns, Anita J.W.M.

AU - Degens, Juliette H.R.J.

AU - Hendriks, Lizza E.L.

AU - Wong, Dennis R.

AU - van Geel, Robin M.J.M.

AU - Croes, Sander

PY - 2025/11/1

Y1 - 2025/11/1

N2 - High exposures of osimertinib are associated with toxicity, and evidence for efficacy at low exposures is scarce: therapeutic drug monitoring can be applied to minimize toxicity while maintaining expected effectiveness. CYP3A polymorphisms may cause substantial deviations in osimertinib exposure, potentially leading to increased toxicity. Comedication which induces CYP3A may substantially decrease osimertinib exposure, potentially resulting in subtherapeutic exposures.

AB - High exposures of osimertinib are associated with toxicity, and evidence for efficacy at low exposures is scarce: therapeutic drug monitoring can be applied to minimize toxicity while maintaining expected effectiveness. CYP3A polymorphisms may cause substantial deviations in osimertinib exposure, potentially leading to increased toxicity. Comedication which induces CYP3A may substantially decrease osimertinib exposure, potentially resulting in subtherapeutic exposures.

KW - Case series

KW - Dose frequency adjustment

KW - Non-small cell lung cancer

KW - Osimertinib

KW - Therapeutic Drug Monitoring

U2 - 10.1016/j.cllc.2025.05.012

DO - 10.1016/j.cllc.2025.05.012

M3 - Article

SN - 1525-7304

VL - 26

SP - e496-e502

JO - Clinical Lung Cancer

JF - Clinical Lung Cancer

IS - 7

ER -

Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series

Abstract

Keywords

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