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Shao Y, Hu J, Yao H, Jiang M, Song Z. Case report: Interstitial lung disease of XELOEX chemotherapy with cetuximab in advanced colon cancer induced. Medicine (Baltimore) 2023; 102:e36379. [PMID: 38115308 PMCID: PMC10727633 DOI: 10.1097/md.0000000000036379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION This paper presents a case of a Chinese patient with advanced colon cancer who developed drug-induced interstitial lung disease while undergoing treatment with cetuximab combined with XELOX. PATIENT CONCERNS A 75-year-old man with a history of colon cancer, had metastases in the liver, peritoneum, and lungs, which were initially treated with XELOX and cetuximab (0.4 g) in 2019. However, the lung metastases progressed, and the cetuximab dosage was adjusted to 0.9 g and then readjusted to 0.4 g. DIAGNOSIS In January 2021, computed tomography revealed developed interstitial lung disease, leading to the discontinuation of chemotherapy and cetuximab. INTERVENTIONS Receiving methylprednisolone pulse therapy. OUTCOMES The patient experienced respiratory failure and passed away. The Naranjo Algorithm Assessment score indicated a probable relationship between cetuximab and the adverse event. CONCLUSION This case highlights the need for regular pulmonary imaging examinations during cetuximab therapy, as drug-induced interstitial lung disease may be associated with the dose and duration of treatment.
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Affiliation(s)
- Yanfei Shao
- Department of Pharmacy, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Jieru Hu
- Department of Pharmacy, Lishui Central Hospital and Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, China
| | - Haibo Yao
- Gastrointestinal Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Menglao Jiang
- Zhejiang Center of Drug and Cosmetics Evaluation, Hangzhou, China
| | - Zhouye Song
- Department of Pharmacy, Zhejiang Hospital, Hangzhou, China
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2
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Du Y, Li T, Yi M. Is MG53 a potential therapeutic target for cancer? Front Endocrinol (Lausanne) 2023; 14:1295349. [PMID: 38033997 PMCID: PMC10684902 DOI: 10.3389/fendo.2023.1295349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Cancer treatment still encounters challenges, such as side effects and drug resistance. The tripartite-motif (TRIM) protein family is widely involved in regulation of the occurrence, development, and drug resistance of tumors. MG53, a member of the TRIM protein family, shows strong potential in cancer therapy, primarily due to its E3 ubiquitin ligase properties. The classic membrane repair function and anti-inflammatory capacity of MG53 may also be beneficial for cancer prevention and treatment. However, MG53 appears to be a key regulatory factor in impaired glucose metabolism and a negative regulatory mechanism in muscle regeneration that may have a negative effect on cancer treatment. Developing MG53 mutants that balance the pros and cons may be the key to solving the problem. This article aims to summarize the role and mechanism of MG53 in the occurrence, progression, and invasion of cancer, focusing on the potential impact of the biological function of MG53 on cancer therapy.
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Affiliation(s)
- Yunyu Du
- School of Sports Science, Beijing Sport University, Beijing, China
- National Institute of Sports Medicine, Beijing, China
| | - Tieying Li
- National Institute of Sports Medicine, Beijing, China
| | - Muqing Yi
- National Institute of Sports Medicine, Beijing, China
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3
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Li X, Wang F, Jia H, Lian Z, Ren K, Yuan Z, Wang P, Zhao L. Efficacy and safety of EGFR inhibitors and radiotherapy in locally advanced non-small-cell lung cancer: a meta-analysis. Future Oncol 2022; 18:3055-3065. [PMID: 35947522 DOI: 10.2217/fon-2022-0491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the efficacy and safety of EGFR inhibitors combined with (chemo)radiotherapy in unresectable, locally advanced non-small-cell lung cancer. Materials & methods: A systematic review and meta-analysis of prospective trials was performed. Results: Twenty-eight studies of 1640 patients were included. In patients harboring EGFR-sensitive mutations, the pooled objective response rate, 1-year overall survival rate and 1-year progression-free survival rate of EGFR-TKIs + (chemo)radiotherapy were 0.803, 0.766 and 0.554, respectively. Compared with chemoradiotherapy, the addition of EGFR inhibitors did not significantly increase the risk of grade ≥3 pneumonitis and esophagitis. Conclusion: EGFR-tyrosine kinase inhibitors combined with (chemo)radiotherapy are tolerable and the clinical benefit is promising, especially in patients with EGFR-sensitive mutations.
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Affiliation(s)
- Xue Li
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Fang Wang
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding, 071000, China
| | - Huijun Jia
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Zhen Lian
- Department of Emergency, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Kai Ren
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Zhiyong Yuan
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Ping Wang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Lujun Zhao
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
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4
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Severe interstitial pneumonia caused by cetuximab: a case report and review of the literature. Anticancer Drugs 2021; 32:1123-1126. [PMID: 34261916 DOI: 10.1097/cad.0000000000001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cetuximab is an IgG1 chimeric mAb against epidermal growth factor receptor, which can be used for chemotherapy failure or tolerance in patients with epidermal growth factor receptor expressed RAS wild-type metastatic colorectal cancer. We report on a patient who developed rapid-onset interstitial pneumonia while being treated with cetuximab plus XELOX (oxaliplatin, capecitabine) for metastatic colorectal cancer. A 75-year-old man patient was administered cetuximab plus XELOX regularly. After his cetuximab schedule was adjusted from 1 to 2 weeks, he rapidly developed interstitial pneumonia which led to acute respiratory distress syndrome. Our literature review indicated that, for patients with risk factors, a 2-week regimen of cetuximab might lead to interstitial pneumonia. Clinicians should closely monitor patients for adverse drug reactions to improve drug safety.
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Nardone V, Calvanese MG, D'Onofrio I, Di Stasio M, Vitale C, Silvestri A, Daniele B, Correale P, Fierro P, Tortoriello G, Reginelli A, Cappabianca S, Guida C. Neck emphysema in a HNSCC cancer patient undergoing concurrent radiotherapy and cetuximab. Rep Pract Oncol Radiother 2020; 25:396-398. [PMID: 32322179 DOI: 10.1016/j.rpor.2020.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/31/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022] Open
Abstract
Background Lung toxicity in patients undergoing cetuximab and radiotherapy (Cetux-RT) for head and neck squamous cell carcinoma (HNSCC) has been reported in literature and represents a serious side effect of concurrent therapies. Methods We report a case of a HNSCC patient that developed neck emphysema during the course of Cetux-RT. The patient was an old male (80 years old) in a good performance status, with an oropharyngeal cancer (T4aN3a). Results During RT, cone-beam computed tomography (CBCT) showed bilateral neck emphysema that was confirmed at restaging CT. We decided to stop the treatment and to treat the neck emphysema with conservative strategies. After one week CT was repeated and the neck emphysema had improved, so we decided to complete the RT treatment. Conclusions Patients undergoing Cetux-RT must be properly selected, whereas IGRT imaging must be viewed carefully in order to permit an early diagnosis and careful management of the patients.
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Affiliation(s)
- Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Via E. Russo 1, 80147 Naples, Italy
| | | | - Ida D'Onofrio
- Unit of Radiation Oncology, Ospedale del Mare, Via E. Russo 1, 80147 Naples, Italy
| | | | - Claudio Vitale
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Bruno Daniele
- Unit of Medical Oncology, Ospedale del Mare, Naples, Italy
| | - Pierpaolo Correale
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli", Reggio Calabria, Italy
| | - Paolo Fierro
- Unit of Otorhinolaryngology, Ospedale del Mare, Naples, Italy
| | | | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, Via E. Russo 1, 80147 Naples, Italy
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6
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Nakano K, Seto A, Sasaki T, Shimbashi W, Fukushima H, Yonekawa H, Mitani H, Takahashi S. Incidence and risk factors of interstitial lung disease of patients with head and neck cancer treated with cetuximab. Head Neck 2019; 41:2574-2580. [PMID: 30828911 DOI: 10.1002/hed.25727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/15/2019] [Accepted: 02/19/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Interstitial lung disease (ILD) is known as a potentially severe adverse event associated with epidermal growth factor receptor (EGFR)-targeted therapy. The incidence and risk factors of ILD in patients with head and neck squamous cancer (HNSCC) treated with cetuximab, an anti-EGFR monoclonal antibody, have not been established. METHODS We retrospectively reviewed patients with HNSCC who received cetuximab from December 2012 to December 2016 at our institute and evaluated the incidence and risk factors of ILD. RESULTS Of the 201 patients with HNSCC, ILD was observed in 9 patients (4.5%), 8 of whom had grade 3 or higher. High Krebs von den Lungen-6 (KL-6) and ≥50 pack-years of smoking were significantly predictive of associated with ILD (P = 0.00011 and 0.05, respectively). CONCLUSION The incidence of ILD in patients with HNSCC treated with cetuximab was <5%, but most of the ILD cases were severe. High KL-6 and smoking histories might be predictive for ILD among patients with HNSCC.
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Affiliation(s)
- Kenji Nakano
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akira Seto
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toru Sasaki
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Wataru Shimbashi
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hirofumi Fukushima
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Yonekawa
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroki Mitani
- Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
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7
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Mayfield JD, Mercado CE, Kaye FJ, Mendenhall WM. Cetuximab-associated pulmonary toxicity in concurrent chemoradiation for the treatment of a squamous cell carcinoma of the head and neck. Head Neck 2019; 41:E55-E58. [PMID: 30614125 DOI: 10.1002/hed.25528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/05/2018] [Accepted: 10/09/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cetuximab is a common EGFR monoclonal antibody used with radiotherapy to treat head-and-neck cancer. Severe pulmonary toxicity, including interstitial lung disease (ILD), caused by cetuximab is rare. METHODS We describe a patient who developed ILD and acute respiratory failure after concurrent chemoradiation with cetuximab for oropharyngeal squamous cell carcinoma, and review the literature. RESULTS A patient developed acute respiratory failure 2 months after starting concurrent chemoradiation with cetuximab and was hospitalized in intensive care after a procedure for progressive respiratory distress. Cultures and serology were negative for infection and radiologic findings were consistent with drug associated pneumonitits. Steroids were administered until the patient was stabilized. The patient fully recovered 1 month after the onset of respiratory distress, although he died of recurrent disease 10 months after completing treatment. CONCLUSION Although severe pulmonary toxicity caused by EGFR inhibitors has been well described in the literature, ILD caused by cetuximab, an EGFR monoclonal antibody, is rare and not well-documented. Given its life-threatening effects, awareness of this potential side effect and early diagnosis is critical.
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Affiliation(s)
- John D Mayfield
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Catherine E Mercado
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Frederic J Kaye
- Division of Medical Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
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8
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Interstitial Lung Disease Associated With Cetuximab in Patients With Head and Neck Carcinoma: A Single-Institution Experience in Japan. Int Surg 2018. [DOI: 10.9738/intsurg-d-16-00256.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:
This study retrospectively analyzed the risk of interstitial lung disease with cetuximab using risk factors known to be associated with interstitial lung disease during administration of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI).
Summary of background data:
Cetuximab is an inhibitor of EGFR commonly used for advanced squamous cell carcinoma of the head and neck. Interstitial lung disease is a rare but serious adverse event of cetuximab. EGFR-TKIs are molecularly targeted drugs resembling cetuximab and show increased risk of interstitial lung disease associated with positive smoking history, age >55 years, preexisting lung disorder, and poor performance status.
Methods:
Among 44 patients treated with cetuximab for advanced squamous cell carcinoma of the head and neck between March 2013 and April 2015 at Tokyo Medical University, 6 patients developed interstitial lung disease. Smoking history, age, preexisting lung disorder, and performance status were examined for these 6 patients.
Results:
Two of these 6 patients died due to interstitial lung disease. All patients with interstitial lung disease were >55 years old and had a history of smoking. Three patients with interstitial lung disease had a preexisting lung disorder. Performance status was 0 in 4 patients and 1 in 2 patients.
Conclusions:
Age >55 years, smoking history, and preexisting lung disease may represent risk factors for interstitial lung disease during cetuximab treatment for head and neck carcinoma, whereas performance status may not.
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9
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Al-Asadi O, Almusarhed M, Rizvi SAJ, Saka W. Fatal interstitial lung disease caused by Panitumumab-containing chemotherapy regimen. Ecancermedicalscience 2018; 12:841. [PMID: 30034518 PMCID: PMC6027982 DOI: 10.3332/ecancer.2018.841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Indexed: 11/21/2022] Open
Abstract
Fatal interstitial lung disease (ILD) is one of the rare side effects of Panitumumab. Both fatal and non-fatal ILD have been reported mainly in the Japanese population. We report a case of a nonsmoking Caucasian man with the diagnosis of metastatic rectal cancer (K-RAS wild-type) who developed fatal ILD after receiving a Panitumumab-containing chemotherapy regimen. He initially presented with a locally advanced rectal cancer (T3N2M0) for which he received neoadjuvant chemoradiotherapy. Before the rectal surgery, he was found to have liver metastases which were considered potentially resectable. The decision was to delay the rectal surgery and to start systemic treatment. He was started on Modified De Gramont regimen (folinic acid and fluorouracil) plus Oxaliplatin with Panitumumab. Six months later, he underwent rectal surgery which showed a complete response. He continued on systemic treatment while awaiting liver metastasectomy. After three courses of Modified De Gramont plus Oxaliplatin with Panitumumab, he was admitted with few days’ history of increasing shortness of breath. High-resolution computed tomography of the lungs showed the features of interstitial pneumonitis. Despite receiving appropriate treatment, he continued to deteriorate and died due to respiratory failure.
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Affiliation(s)
- Osamah Al-Asadi
- Department of Oncology, Milton Keynes University Hospital, NHS Foundation Trust, Standing Way, MK65LD, UK.,School of Medicine, University of Buckingham, Buckingham MK18 1EG, UK
| | - Manar Almusarhed
- Department of Oncology, Milton Keynes University Hospital, NHS Foundation Trust, Standing Way, MK65LD, UK.,School of Medicine, University of Buckingham, Buckingham MK18 1EG, UK.,University of Babylon, Hillah 51002, Iraq
| | - Syed Azhar J Rizvi
- Department of Oncology, Milton Keynes University Hospital, NHS Foundation Trust, Standing Way, MK65LD, UK
| | - Wasiru Saka
- Department of Oncology, Milton Keynes University Hospital, NHS Foundation Trust, Standing Way, MK65LD, UK
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10
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Parrot A, Gibelin A, Issoufaly T, Voiriot G, Djibré M, Naccache J, Cadranel J, Fartoukh M. Toxicité pulmonaire des médicaments : ce que le réanimateur doit connaître ? MEDECINE INTENSIVE REANIMATION 2018. [DOI: 10.3166/rea-2018-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Price L, Glynn P, Zarkar A. Interstitial lung disease secondary to Cetuximab in bladder cancer: an Oncologist's perspective. BMJ Case Rep 2017; 2017:bcr-2017-220181. [PMID: 29269357 DOI: 10.1136/bcr-2017-220181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A wide variety of cytotoxic medications cause interstitial lung disease (ILD). For the first time, we describe ILD in an 82-year-old woman with muscle invasive bladder cancer 10 days after receiving cetuximab as part of a novel trial. She had no significant medical history or drug allergies, had good exercise tolerance and a 5 pack-year smoking history. She received neoadjuvant chemotherapy (gemcitabine, cisplatin) with a good response on MRI. She was eligible for a phase 2 trial of cetuximab with chemotherapy and radiotherapy for muscle invasive bladder cancer (TUXEDO), in which the trial arm used cetuximab plus standard chemoradiotherapy to the bladder (64 grey in 32 fractions plus mitomycinandfluorouracil). Ten days after her third infusion of cetuximab, she was presented with type 1 respiratory failure. Thoracic CT scan demonstrated new widespread ground glass change in the lungs. She received high-dose steroids (prednisolone 1 mg/kg), broad spectrum antibacterial cover and non-invasive ventilation. She survived to be discharged with residual respiratory failure.
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Affiliation(s)
- Louise Price
- The Cancer Centre, Queen Elizabeth Hospital Birmingham, Birmingham, UK.,The Deanesly Centre, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Patricia Glynn
- The Cancer Centre, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Anjali Zarkar
- The Cancer Centre, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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12
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Shah RR. Tyrosine Kinase Inhibitor-Induced Interstitial Lung Disease: Clinical Features, Diagnostic Challenges, and Therapeutic Dilemmas. Drug Saf 2017; 39:1073-1091. [PMID: 27534751 DOI: 10.1007/s40264-016-0450-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Since the approval of the first molecularly targeted tyrosine kinase inhibitor (TKI), imatinib, in 2001, TKIs have heralded a new era in the treatment of many cancers. Among their innumerable adverse effects, interstitial lung disease (ILD) is one of the most serious, presenting most frequently with dyspnea, cough, fever, and hypoxemia, and often treated with steroids. Of the 28 currently approved TKIs, 16 (57 %) are reported to induce ILD with varying frequency and/or severity. The interval from drug administration to onset of ILD varies between patients and between TKIs, with no predictable time course. Its incidence is variously reported to be approximately 1.6-4.3 % in Japanese populations and 0.3-1.0 % in non-Japanese populations. The mortality rate is in the range of 20-50 %. Available evidence (primarily following the use of erlotinib and gefitinib in Japan because of the unique susceptibility of that population) has identified a number of susceptibility and prognostic risk factors (male sex, a history of smoking, and pre-existing pulmonary fibrosis being the main ones). Although the precise mechanism is not understood, collective evidence suggests that immune factors may be involved. If TKI-induced ILD is confirmed by thorough evaluation of the patient and exclusion of other causes, management is supportive, and includes discontinuation of the culprit TKI and administration of steroids. Discontinuing the culprit TKI presents a clinical dilemma because the diagnosis of TKI-induced ILD in a patient with pre-existing pulmonary fibrosis can be challenging, the patient may have TKI-responsive cancer with no suitable alternative, and switching to an alternative agent, even if available, carries the risk of the patient experiencing other toxic effects. Preliminary evidence suggests that therapy with the culprit TKI may be continued under steroid cover and/or at a reduced dose. However, this approach requires careful individualized risk-benefit analysis and further clinical experience.
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Affiliation(s)
- Rashmi R Shah
- Pharmaceutical Consultant, 8 Birchdale, Gerrards Cross, Buckinghamshire, UK.
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13
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Mitsuboshi S, Kozakai H, Yamada H, Nagai K, Furukawa T, Aizawa K. Interstitial lung disease following FOLFOX + FOLFIRI and bevacizumab therapy associated with leucovorin: A case report. J Oncol Pharm Pract 2017; 24:540-543. [PMID: 28696176 DOI: 10.1177/1078155217718616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Chemotherapy-induced interstitial lung disease in colorectal cancer patients is rare but represents a life-threatening adverse reaction. We report here a case of interstitial lung disease following chemotherapy for metastatic colorectal cancer and the interesting results of the drug-induced lymphocyte stimulation test and leukocyte migration test. After chemotherapy with oxaliplatin plus infusional 5-fluorouracil and leucovorin (FOLFOX) plus bevacizumab followed by irinotecan plus infusional 5-fluorouracil and leucovorin (FOLFIRI), the patient was hospitalized with fever and chills. Laboratory data showed neutropenia and eosinophilia. Computed tomography revealed ground-glass opacities in both lungs; therefore, we diagnosed chemotherapy-induced interstitial lung disease. Steroid therapy was effective. We suspected irinotecan to be the etiological drug for interstitial lung disease in this patient because interstitial lung disease developed after switching the regimen from FOLFOX to FOLFIRI. However, drug-induced lymphocyte stimulation test and leukocyte migration test results were positive for only leucovorin and negative for irinotecan and 5-fluorouracil. This is the first case to show positive results on the drug-induced lymphocyte stimulation test and leukocyte migration test for only leucovorin and negative results for antineoplastic drugs. Our findings suggest that all drugs included in chemotherapy regimens have the potential to induce interstitial lung disease, and if rechallenge chemotherapy is considered, the drug-induced lymphocyte stimulation test and leukocyte migration test are expected to be useful for determining the drug that needs to be excluded.
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Affiliation(s)
- Satoru Mitsuboshi
- 1 Department of Pharmacy, Kaetsu Hospital, Niigata-shi, Niigata, Japan
| | - Hiromi Kozakai
- 1 Department of Pharmacy, Kaetsu Hospital, Niigata-shi, Niigata, Japan
| | - Hitoshi Yamada
- 1 Department of Pharmacy, Kaetsu Hospital, Niigata-shi, Niigata, Japan
| | - Kazuhiko Nagai
- 1 Department of Pharmacy, Kaetsu Hospital, Niigata-shi, Niigata, Japan
| | - Tomoyasu Furukawa
- 2 Department of Pharmaceuticals, Niitsu Medical Center Hospital, Niigata-shi, Niigata, Japan
| | - Kikuo Aizawa
- 3 Department of Surgery, Kaetsu Hospital, Niigata-shi, Niigata, Japan
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14
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Mattar RE, Al-alem F, Simoneau E, Hassanain M. Preoperative selection of patients with colorectal cancer liver metastasis for hepatic resection. World J Gastroenterol 2016; 22:567-581. [PMID: 26811608 PMCID: PMC4716060 DOI: 10.3748/wjg.v22.i2.567] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/24/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023] Open
Abstract
Surgical resection of colorectal liver metastases (CRLM) has a well-documented improvement in survival. To benefit from this intervention, proper selection of patients who would be adequate surgical candidates becomes vital. A combination of imaging techniques may be utilized in the detection of the lesions. The criteria for resection are continuously evolving; currently, the requirements that need be met to undergo resection of CRLM are: the anticipation of attaining a negative margin (R0 resection), whilst maintaining an adequate functioning future liver remnant. The timing of hepatectomy in regards to resection of the primary remains controversial; before, after, or simultaneously. This depends mainly on the tumor burden and symptoms from the primary tumor. The role of chemotherapy differs according to the resectability of the liver lesion(s); no evidence of improved survival was shown in patients with resectable disease who received preoperative chemotherapy. Presence of extrahepatic disease in itself is no longer considered a reason to preclude patients from resection of their CRLM, providing limited extra-hepatic disease, although this currently is an area of active investigations. In conclusion, we review the indications, the adequate selection of patients and perioperative factors to be considered for resection of colorectal liver metastasis.
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Kurokawa M, Watanabe Nemoto M, Harada R, Kobayashi H, Horikoshi T, Kanazawa A, Togasaki G, Abe Y, Chazono H, Hanazawa T, Okamoto Y, Uno T. Initial experience of radiotherapy plus cetuximab for Japanese head and neck cancer patients. JOURNAL OF RADIATION RESEARCH 2015; 56:849-855. [PMID: 26160181 PMCID: PMC4577007 DOI: 10.1093/jrr/rrv038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/19/2015] [Accepted: 05/23/2015] [Indexed: 06/04/2023]
Abstract
In Japan, cetuximab with concurrent bioradiotherapy (BRT) for squamous cell carcinoma of head and neck (SCCHN) was approved in December 2012. We herein report our initial experience of BRT, with special emphasis on acute toxicities of this combination therapy. Thirty-one non-metastatic SCCHN patients who underwent BRT using cetuximab between July 2013 and June 2014 were retrospectively evaluated. All patients received cetuximab with a loading dose of 400 mg/m(2) one week before the start of radiotherapy, followed by 250 mg/m(2) per week during radiotherapy. The median cycle of cetuximab was seven cycles and the median dose of radiotherapy was 70 Gy. Twenty-five patients (80.6%) accomplished planned radiotherapy and six cycles or more cetuximab administration. Six patients (19.4%) discontinued cetuximab. Grade 3 dermatitis, mucositis and infusion reaction occurred in 19.4%, 48.3% and 3.2%, respectively. One patient experienced Grade 3 gastrointestinal bleeding caused by diverticular hemorrhage during BRT. Grade 3 drug-induced pneumonitis occurred in two patients. The response rate was 74%, including 55% with a complete response. BRT using cetuximab for Japanese patients with SCCHN was feasible as an alternative for cisplatin-based concurrent chemoradiation, although longer follow-up is necessary to evaluate late toxicities.
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Affiliation(s)
- Marie Kurokawa
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Miho Watanabe Nemoto
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Rintaro Harada
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Hiroki Kobayashi
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Takuro Horikoshi
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Aki Kanazawa
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Gentaro Togasaki
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Yukinao Abe
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Hideaki Chazono
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Toyoyuki Hanazawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Takashi Uno
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
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16
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Soura E, Chasapi V, Stratigos AJ. Pharmacologic treatment options for advanced epithelial skin cancer. Expert Opin Pharmacother 2015; 16:1479-93. [DOI: 10.1517/14656566.2015.1052743] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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17
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Osawa M, Kudoh S, Sakai F, Endo M, Hamaguchi T, Ogino Y, Yoneoka M, Sakaguchi M, Nishimoto H, Gemma A. Clinical features and risk factors of panitumumab-induced interstitial lung disease: a postmarketing all-case surveillance study. Int J Clin Oncol 2015; 20:1063-71. [PMID: 25967287 PMCID: PMC4666285 DOI: 10.1007/s10147-015-0834-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 04/14/2015] [Indexed: 12/03/2022]
Abstract
Background Drug-induced interstitial lung disease (ILD) is one of the most serious adverse reactions associated with the molecularly targeted drugs. Panitumumab has been approved for advanced or recurrent colorectal cancer. Although there were no adverse reaction reports of ILD in panitumumab monotherapy, 4 cases in combination chemotherapy were reported prior to its approval in Japan in 2010. Several studies also reported that the incidence of drug-induced ILD was higher in Japan than in other countries. The clinical features of ILD and the associated risk factors therefore need investigation. Methods We analyzed the data from 3085 unresectable, advanced or recurrent colorectal cancer patients enrolled in a postmarketing all-case surveillance study of panitumumab in Japan. ILD case reports were assessed based on the clinical and radiologic findings by a committee of external experts. Multivariate analysis using Cox’s hazard model identified the risk factors. Results ILD incidence (1.3 %) and mortality rates (51.3 %) were similar to those of patients receiving another anti-epidermal growth factor receptor (EGFR) monoclonal antibody in Japan. No specific onset timing was determined. Although panitumumab-specific ILD findings were not observed in computed tomography images or clinical practice, panitumumab can induce ILD with diffuse alveolar damage, as do the other anti-EGFR targeting drugs. A history/complication of ILD, male sex, poor general condition, and 65 years or older were identified as ILD risk factors, and no history of previous drug treatment was an apparent risk factor. Conclusion Panitumumab-induced ILD can occur at any time after initiation, and close and regular monitoring is needed.
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Affiliation(s)
- Masahiro Osawa
- Pharmacovigilance Department, Takeda Pharmaceutical Company Limited, 4-9, Hiranomachi 2-chome, Chuo-ku, Osaka, 541-0046, Japan.
| | - Shoji Kudoh
- Fukujuji Hospital, Kiyose, Japan.,Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Fumikazu Sakai
- Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Masahiro Endo
- Division of Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-Cho, Shizuoka, Japan
| | - Tetsuya Hamaguchi
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yumiko Ogino
- Pharmacovigilance Department, Takeda Pharmaceutical Company Limited, 4-9, Hiranomachi 2-chome, Chuo-ku, Osaka, 541-0046, Japan
| | - Miyo Yoneoka
- Pharmacovigilance Department, Takeda Pharmaceutical Company Limited, 4-9, Hiranomachi 2-chome, Chuo-ku, Osaka, 541-0046, Japan
| | - Motonobu Sakaguchi
- Pharmacovigilance Department, Takeda Pharmaceutical Company Limited, 4-9, Hiranomachi 2-chome, Chuo-ku, Osaka, 541-0046, Japan
| | - Hiroyuki Nishimoto
- Pharmacovigilance Department, Takeda Pharmaceutical Company Limited, 4-9, Hiranomachi 2-chome, Chuo-ku, Osaka, 541-0046, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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