Diffuse alveolar damage after ZD1839 therapy in a patient with non-small cell lung cancer.
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.
Okamoto
Isamu
I
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
Fujii
Kazuhiko
K
Matsumoto
Mitsuhiro
M
Terasaki
Yasuhiro
Y
Kihara
Nanae
N
Kohrogi
Hirotsugu
H
Suga
Moritaka
M
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*
D000970:Antineoplastic Agents; D011799:Quinazolines; D004815:Epidermal Growth Factor; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib