title: Severe acute interstitial pneumonia and gefitinib.
abstract: 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.
authors.affiliation: 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
authors.forename: Akira
authors.initials: A
authors.lastname: Inoue
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Saijo
authors.forename: Makoto
authors.initials: M
authors.lastname: Maemondo
authors.forename: Kazunori
authors.initials: K
authors.lastname: Gomi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokue
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kimura
authors.forename: Masahito
authors.initials: M
authors.lastname: Ebina
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Takuya
authors.initials: T
authors.lastname: Moriya
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nukiwa
mesh_terms: 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*
chemical_list: D011799:Quinazolines; D000077156:Gefitinib