Gefitinib-induced interstitial lung disease showing improvement after cessation: disassociation of serum markers.
Gefitinib (ZD1839), a small-molecule epidermal growth factor receptor tyrosine kinase inhibitor, is an anticancer agent for patients with non-small cell lung carcinoma. Recently, however, as a result of accumulating evidence, it has been recognized that gefitinib can give rise to lethal lung toxicity. The authors report a case of interstitial lung disease (ILD) induced by gefitinib, which improved promptly following cessation of the administration of the agent. Clinical signs suggesting a good prognosis were noted, namely, findings similar to acute eosinophilic pneumonia on CT and a disassociation in the elevation of specific serum markers of ILD. At the time of onset of ILD, serum concentrations of surfactant protein (SP)-A and SP-D were significantly increased, whereas that of KL-6 was not increased. A previous study of three cases of lethal lung toxicity resulting from gefitinib administration revealed a significant and almost equal increase in KL-6, SP-A and SP-D. These results suggest that SP-A and SP-D may be indicators of gefitinib-induced ILD and that KL-6 is a predictor of outcome. Using a combination of these markers may help to establish a differential prognosis in patients with gefitinib-induced ILD.
Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Hiroko
H
Kitajima
Hiroki
H
Takahashi
Kazutoki
K
Harada
Akiko
A
Kanai
Shin-Ichiro
S
Inomata
Haruko
H
Taniguchi
Toyohiro
T
Saikai
Shosaku
S
Abe
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000951:Antigens, Neoplasm / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D000077156:Gefitinib; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins / Q000097:blood; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood*; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins; D037662:Pulmonary Surfactant-Associated Protein A; D037663:Pulmonary Surfactant-Associated Protein D; D011799:Quinazolines; D000077156:Gefitinib