Supplementary Material for: A case: Thrombocytopenia in an EGFR 19 exon-deficient bilateral diffuse LUAD with ARDS treated with ECMO and Osimertinib

Introduction: EGFR-sensitive mutations bilateral-diffuse lung adenocarcinoma (LUAD) complicated with acute respiratory distress syndrome (ARDS)is relatively rare. Whether EGFR-TKI can be simultaneously received when treating with extracorporeal membrane oxygenation (ECMO) and anti-infective therapy in these patients, and what adverse events should be noted?
Case Presentation: We report a case of EGFR 19 exon-deficient bilateral diffuse LUAD complicated with ARDS. When treated with ECMO and anti-infective therapy, the patient received oral Osimertinib anti-tumor therapy simultaneously. The tumor receded, but eventually irreversible thrombocytopenia developed.
Conclusion: For patients with severe lung cancer, anti-tumor efficacy and adverse events should be closely observed during anti-tumor therapy.

引言：伴表皮生长因子受体敏感突变（EGFR-sensitive mutations）的双侧弥漫性肺腺癌（LUAD）合并急性呼吸窘迫综合征（ARDS）相对少见。此类患者在接受体外膜肺氧合（ECMO）与抗感染治疗的同时，能否应用表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）？治疗过程中需关注哪些不良事件？

病例报告：本文报道1例伴EGFR 19号外显子缺失突变的双侧弥漫性肺腺癌合并急性呼吸窘迫综合征患者。该患者在接受ECMO与抗感染治疗期间，同时予以口服奥希替尼（Osimertinib）行抗肿瘤治疗。治疗后肿瘤病灶缩小，但最终出现不可逆性血小板减少症。

结论：对于重度肺癌患者，在抗肿瘤治疗过程中需密切监测抗肿瘤疗效与不良事件的发生。