Severe acute interstitial pneumonia and gefitinib.
Gefitinib is an oral selective inhibitor of the epidermal growth factor receptor tyrosine kinase that is an effective treatment for patients with advanced non-small cell lung cancer who do not respond to platinum-based chemotherapy. We assessed four patients who had non-small cell lung cancer causing severe acute interstitial pneumonia in association with gefitinib. Although two patients recovered after treatment with steroids, the other two died from progressive respiratory dysfunction. On the basis of autopsies and bilateral distribution of diffuse ground-glass opacities in chest CTs, we diagnosed diffuse alveolar damage, which was consistent with acute interstitial pneumonia. Patients with interstitial pneumonia also had other pulmonary disorders such as previous thoracic irradiation and poor performance status. Physicians should be aware of the alveolar damage induced by gefitinib, especially for patients with these characteristic features.
Inoue
Akira
A
Department of Respiratory Oncology and Molecular Medicine, Institute of Development, Aging, and Cancer, Tohoku University, Aobaku, Sendai, 980-8575, Toyko, Japan. akinoue@idac.tohoku.ac.jp
Saijo
Yasuo
Y
Maemondo
Makoto
M
Gomi
Kazunori
K
Tokue
Yutaka
Y
Kimura
Yuichiro
Y
Ebina
Masahito
M
Kikuchi
Toshiaki
T
Moriya
Takuya
T
Nukiwa
Toshihiro
T
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D005260:Female; D000077156:Gefitinib; D006801:Humans; D007564:Japan; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000401:mortality / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*
D011799:Quinazolines; D000077156:Gefitinib