Irinotecan-associated pulmonary toxicity.
We present the circumstances surrounding a 57-year-old Caucasian man with advanced colorectal cancer who developed relapsing interstitial lung disease following a single exposure to irinotecan (CPT-11). Progressive pulmonary insufficiency and death were reported in the initial Japanese studies, despite institution of empiric steroid therapy for a syndrome similar to that which our patient experienced. As a result, patients with compromised pulmonary function were generally excluded from US clinical trials. Notwithstanding this, cough and dyspnea were reported in approximately 20% of patients in the US studies. As the clinical indications for the use of this agent expand, we describe irinotecan-associated interstitial pneumonitis as a serious potential adverse effect. Patients with pre-existing pulmonary disease may be at higher risk for this complication and clinicians should be alert to this possibility.
Madarnas
Y
Y
Division of Medical Oncology/Hematology, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada. yolanda.madarnas@krcc.on.ca
Webster
P
P
Shorter
A M
AM
Bjarnason
G A
GA
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy; D006801:Humans; D000077146:Irinotecan; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged
D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin