# A real-world pharmacovigilance study of FDA Adverse Event Reporting System (FAERS) events for osimertinib

**Authors:** Yanchao Yin, Yamin Shu, Junru Zhu, Feie Li, Juan Li

PMC · DOI: 10.1038/s41598-022-23834-1 · Scientific Reports · 2022-11-15

## TL;DR

This study analyzed real-world data to identify adverse events linked to the cancer drug osimertinib, revealing new safety signals for clinical monitoring.

## Contribution

The study identifies new and unexpected adverse event signals for osimertinib using FAERS data and disproportionality analysis.

## Key findings

- Osimertinib caused adverse events in 27 organ systems, with 68 significant signals detected.
- Unexpected AEs like scrotal volvulus and venous thromboembolisms were identified.
- Most AEs occurred within 30 days of starting osimertinib, with a median onset of 58 days.

## Abstract

Osimertinib was a third-generation, irreversible epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), which approved by the US Food and Drug Administration (FDA) in 2015 for treatment of non-small cell lung cancer (NSCLC). Our study was to explore the adverse events (AEs) caused by osimertinib through data mining of the US FDA Adverse Event Reporting System (FAERS), and provide reference for clinical safety. Data of osimertinib were collected from the FAERS database covering the period from first quarter of 2016 to the fourth quarter of 2021. Disproportionality analyses was employed to quantify the associated AE signals of osimertinib and detect the risk signals from the data in the FAERS database. Reporting odds ratio (ROR) was used to detect the risk signals from the data in the FAERS database. The definition relied on system organ class (SOCs) and preferred terms (PTs) by the Medical Dictionary for Regulatory Activities (MedDRA). Totally, 9,704,33 reports were collected from the FAERS database, 10,804 reports of osimertinib were identified as the ‘primary suspected (PS)’ AEs. Osimertinib induced AEs occurred in 27 organ systems. 68 significant disproportionality PTs satisfying with the four algorithms were retained at the same time. Unexpected significant AEs such as scrotal volvulus, hepatic function abnormal, venous thromboembolisms might also occur. The median onset time of osimertinib-associated AEs was 58 days (interquartile range [IQR] 14–212 days), and the majority of the AEs occurred within the first 30 days after osimertinib initiation. Our study found significant new AEs signals of osimertinib and might provide support for clinical monitoring and risk identification of osimertinib.

## Linked entities

- **Chemicals:** osimertinib (PubChem CID 71496458)
- **Diseases:** non-small cell lung cancer (MONDO:0005233)

## Full-text entities

- **Genes:** CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, ALK (ALK receptor tyrosine kinase) [NCBI Gene 238] {aka ALK1, CD246, NBLST3}, EPHB2 (EPH receptor B2) [NCBI Gene 2048] {aka BDPLT22, CAPB, DRT, EK5, EPHT3, ERK}, KDR (kinase insert domain receptor) [NCBI Gene 3791] {aka CD309, FLK1, VEGFR, VEGFR2}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673] {aka B-RAF1, B-raf, BRAF-1, BRAF1, NS7, RAFB1}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, MAP3K8 (mitogen-activated protein kinase kinase kinase 8) [NCBI Gene 1326] {aka AURA2, COT, EST, ESTF, MEKK8, TPL2}, CYP3A5 (cytochrome P450 family 3 subfamily A member 5) [NCBI Gene 1577] {aka CP35, CYPIIIA5, P450PCN3, PCN3}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}
- **Diseases:** rash (MESH:D005076), lung fibrosis (MESH:D005355), lung cancer (MESH:D008175), nail toxicity (MESH:D009260), immobilisation syndrome (MESH:D013577), Cardiac disorders (MESH:D006331), Myocardial necrosis (MESH:D009336), ILD (MESH:D017563), cutaneous melanoma (MESH:C562393), Cardiomyopathy (MESH:D009202), cerebral infarction (MESH:D002544), pneumonia (MESH:D011014), lung inflammatory (MESH:D016726), Tumor (MESH:D009369), laboratory (MESH:D007757), congenital, familial and genetic disorders (MESH:D030342), System (MESH:D015619), VTE (MESH:D054556), SmPC (MESH:D007787), Eye disorders (MESH:D005128), NSCLC (MESH:D002289), lung injuries (MESH:D055370), AEs (MESH:D064420), Cardiac related AEs (MESH:D002318), atrial fibrillation (MESH:D001281), Death (MESH:D003643), skin disease (MESH:D012871), AURA (MESH:D020325), hepatobiliary disorders (MESH:D004066), chronic obstructive pulmonary disease (MESH:D029424), Lung adenocarcinoma (MESH:D000077192), ileus (MESH:D045823), respiratory diseases (MESH:D012140), Constipation (MESH:D003248), DILI (MESH:D056486), deep vein thrombosis (MESH:D020246), connective tissue (MESH:D003240), failure (MESH:D051437), colon obstruction (MESH:D015179), Pericardial effusion (MESH:D010490), respiratory adverse reactions (MESH:D012130), Lung disorder (MESH:D008171), pulmonary embolism (MESH:D011655), Blood and lymphatic system disorders (MESH:D006425), dry skin (MESH:D015352), paronychia (MESH:D010304), Nervous system disorders (MESH:D009422), pleural effusion (MESH:D010996), inflammatory (MESH:D007249), disorders (MESH:D009358), melanoma (MESH:D008545), hydrothorax (MESH:D006876), ventricular dysfunction (MESH:D018754), pneumothorax (MESH:D011030), cough (MESH:D003371), scrotal volvulus (MESH:D045822), cecal volvulus (MESH:D002429), adenocarcinoma (MESH:D000230), respiratory (MESH:D012131), QT interval prolongation (MESH:D008133)
- **Chemicals:** Trastuzumab (MESH:D000068878), erlotinib (MESH:D000069347), anticancer drugs (-), ADR (MESH:D004317), gefitinib (MESH:D000077156), afatinib (MESH:D000077716), Osimertinib (MESH:C000596361)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606], Coronaviridae (family) [taxon 11118]
- **Mutations:** V600, T790M, serine/threonine

## Full text

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## Figures

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## References

51 references — full list in the complete paper: https://tomesphere.com/paper/PMC9664039/full.md

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Source: https://tomesphere.com/paper/PMC9664039