Osimertinib-associated Membranoproliferative Glomerulonephritis: a Case Report

Osimertinib is a third-generation epidermal growth factor receptor-directed tyrosine kinase inhibitor (EGFR-TKIs) that selectively binds to T790M mutation and used in EGFR-positive non-small cell lung cancer (NSCLC), which has shown to improve progression-free survival. While there have been reports of first- and second-generation EGFR-TKIs causing acute tubulointerstitial nephritis, there have been limited case reports of osimertinib-associated glomerular injury. We describe a case of osimertinib-associated membranoproliferative glomerulonephritis (MPGN) in a patient with advanced Stage IV NSCLC and severe acute kidney injury (AKI), that responded with osimertinib cessation and a course of oral prednisolone. Thus, we recommend a renal biopsy in patients with an acute kidney injury suspected to osimertinib use.