title: Diffuse alveolar damage after ZD1839 therapy in a patient with non-small cell lung cancer.
abstract: ZD1839 is an orally active inhibitor selective for the epidermal growth factor receptor tyrosine kinase and has shown promise in the treatment of non-small cell lung cancer (NSCLC). We now present a case of diffuse alveolar damage (DAD) that developed in a 67-year-old man treated with ZD1839. On day 8 of ZD1839 administration, the patient complained of dyspnea and a new-ground glass opacity was apparent on a chest X-ray and computed tomography scan. Despite high-dose steroid therapy, the patient died 13 days after the first administration of ZD1839. Postmortem analysis of lung tissue revealed a pattern of DAD. No evidence of infection or of other specific etiologies was apparent. This case is the first reported of respiratory failure after ZD1839 treatment in a patient with NSCLC. Physicians should therefore be aware of the potential pulmonary toxicity of ZD1839.
authors.affiliation: First Department of Internal Medicine, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-0811, Japan. isamu@kaiju.medic.kumamoto-u.ac.jp
authors.forename: Isamu
authors.initials: I
authors.lastname: Okamoto
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fujii
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Terasaki
authors.forename: Nanae
authors.initials: N
authors.lastname: Kihara
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kohrogi
authors.forename: Moritaka
authors.initials: M
authors.lastname: Suga
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D004815:Epidermal Growth Factor / Q000037:antagonists & inhibitors; D017809:Fatal Outcome; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011650:Pulmonary Alveoli / Q000187:drug effects* / Q000473:pathology*; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D004815:Epidermal Growth Factor; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib