title: Interstitial lung disease associated with gefitinib.
abstract: Although pulmonary toxicity associated with gefitinib, an epidermal growth factor receptor inhibitor, has been reported recently, the accumulation of clinical information and the underlying mechanisms of gefitinib-induced interstitial lung disease (ILD) remain insufficient and unclear. After retrospectively reviewing the clinical records and chest X-rays of 489 lung cancer patients who were treated with gefitinib, we diagnosed four cases of gefitinib-induced ILD who underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL). We found that the period of time from starting gefitinib to the onset of ILD was short, and concluded that a careful and close observation of a chest imaging study and a collection of respiratory symptoms was recommended. All four patients were treated with a high dose of corticosteroids, and ILD was resolved. We detected high levels of interferon-inducible protein-10 in BAL fluid, although we could not demonstrate the characteristic features of laboratory findings or BAL fluid cell analysis. We speculated that a Th1 type of lung tissue inflammation or lung injury might be involved as a part of mechanisms underlying gefitinib-induced ILD.
authors.affiliation: Department of Medicine, Division of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kataoka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kimura
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishiyama
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Imaizumi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kawabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kume
authors.forename: Kaoru
authors.initials: K
authors.lastname: Shimokata
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D054357:Chemokine CXCL10; D019742:Chemokines, CC / Q000032:analysis; D019743:Chemokines, CXC / Q000378:metabolism; D005260:Female; D000077156:Gefitinib; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D011859:Radiography; D012129:Respiratory Function Tests; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D054357:Chemokine CXCL10; D019742:Chemokines, CC; D019743:Chemokines, CXC; D005938:Glucocorticoids; D011799:Quinazolines; D000077156:Gefitinib; D008775:Methylprednisolone