title: Bortezomib therapy-related lung disease in Japanese patients with multiple myeloma: incidence, mortality and clinical characterization.
abstract: Because of the potentially high mortality rate (6.5%) associated with bortezomib-induced lung disease (BILD) in Japanese patients with relapsed or refractory multiple myeloma, we evaluated the incidence, mortality and clinical features of BILD in a Japanese population. This study was conducted under the Risk Minimization Action Plan (RMAP), which was collaboratively developed by the pharmaceutical industry and public health authority. The RMAP consisted of an intensive dissemination of risk information and a recommended countermeasure to health-care professionals. All patients treated with bortezomib were consecutively registered in the study within 1 year and monitored for emerging BILD. Of the 1010 patients registered, 45 (4.5%) developed BILD, 5 (0.50%) of whom had fatal cases. The median time to BILD onset from the first bortezomib dose was 14.5 days, and most of the patients responded well to corticosteroid therapy. A retrospective review by the Lung Injury Medical Expert Panel revealed that the types with capillary leak syndrome and hypoxia without infiltrative shadows were uniquely and frequently observed in patients with BILD compared with those with conditions associated with other molecular-targeted anticancer drugs. The incidence rate of BILD in Japan remains high compared with that reported in other countries, but the incidence and mortality rates are lower than expected before the introduction of bortezomib in Japan. This study describes the radiographic pattern and clinical characterization of BILD in the Japanese population. The RMAP seemed clinically effective in minimizing the BILD risk among our Japanese population.
authors: Division of Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan.
authors: Kazutake
authors: K
authors: Yoshizawa
authors: Harumi Y
authors: HY
authors: Mukai
authors: Michiko
authors: M
authors: Miyazawa
authors: Makiko
authors: M
authors: Miyao
authors: Yoshimasa
authors: Y
authors: Ogawa
authors: Kazuma
authors: K
authors: Ohyashiki
authors: Takao
authors: T
authors: Katoh
authors: Masahiko
authors: M
authors: Kusumoto
authors: Akihiko
authors: A
authors: Gemma
authors: Fumikazu
authors: F
authors: Sakai
authors: Yukihiko
authors: Y
authors: Sugiyama
authors: Kiyohiko
authors: K
authors: Hatake
authors: Yuh
authors: Y
authors: Fukuda
authors: Shoji
authors: S
authors: Kudoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001897:Boronic Acids / Q000009:adverse effects* / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008171:Lung Diseases / Q000139:chemically induced* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011719:Pyrazines / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib
keywords: Bortezomib; lung disease; mortality; multiple myeloma; proteasome inhibitors