OBJECTIVE  To explore the adjustment strategies for drug therapy in patients with epidermal growth factor receptor(EGFR) positive non-small cell lung cancer complicated by renal insufficiency.

METHODS  Clinical pharmacists participated in the adjustment of the treatment plan for a patient with EGFR-positive non-small cell lung cancer complicated by renal insufficiency. The drug therapy adjustment strategy was analyzed from various aspects, including the formulation and optimization of the treatment plan, assessment of potential risks from drug interactions, and identification of the causes of renal insufficiency. The pharmacists assisted physicians in formulating an individualized drug therapy plan.

RESULTS  For patients with EGFR-positive non-small cell lung cancer with a heavy tumor burden, a targeted combination chemotherapy regimen was selected, and a dose reduction plan was implemented based on pharmacokinetic characteristics and the patient's renal function. Clinical pharmacists assisted physicians in analyzing potential causes of renal insufficiency and assessing the risks of drug interactions. Suspected drugs, including nonsteroidal antiinflammatory drugs, proton pump inhibitors, and bisphosphonates, were discontinued or replaced to prevent and delay the risk of renal toxicity. The physician adopted the pharmacist's recommendations, resulting in a smooth treatment process, and the patient's response was evaluated as partial remission.

CONCLUSION  Clinical pharmacists utilizes their professional expertise, focusing on pharmaceutical care for renal insufficiency as a starting point. They assistes physicians in adjusting medication regimens by ensuring rational drug selection, dose adjustment, management of interactions, and adverse reactions. This approach helps to improve the safety and effectiveness of drug therapy in patients with tumors complicated by renal insufficiency.