Fatal diffuse alveolar damage in two lung transplant patients treated with cetuximab.
Organ transplant recipients are at increased risk for aggressive cutaneous squamous cell carcinomas (cSCC) that recur and metastasize despite treatment with surgery, radiation, or both. Therapies targeting the epidermal growth factor receptor (EGFR) are being explored as treatments for metastatic cSCC. We describe our experience with two single-lung transplant patients who developed metastatic cSCC; failed surgical resection, radiation or chemoradiation therapy; and were ultimately treated with an EGFR inhibitor, cetuximab. Both patients died shortly after initiation of cetuximab due to diffuse alveolar damage, suggesting that EGFR inhibitors should be used with extreme caution in lung transplant recipients.
Leard
Lorriana E
LE
Division of Pulmonary and Critical Care Medicine, University of California at San Francisco, San Francisco, California 94143-0111, USA. lorriana.leard@ucsf.edu
Cho
Bryan K
BK
Jones
Kirk D
KD
Hays
Steven R
SR
Tope
Whitney D
WD
Golden
Jeffrey A
JA
Hoopes
Charles W
CW
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D000068818:Cetuximab; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D017809:Fatal Outcome; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000473:pathology; D016040:Lung Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000187:drug effects / Q000473:pathology*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000188:drug therapy
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000068818:Cetuximab