title: Interstitial lung disease associated with trastuzumab monotherapy: A report of 3 cases.
abstract: We herein report 3 cases of female patients with breast cancer who developed interstitial lung disease (ILD) during trastuzumab monotherapy in an adjuvant setting. Prior chemotherapy included 4 cycles of epirubicin and cyclophosphamide in patients 1 and 2, and 4 cycles of docetaxel, cyclophosphamide and trastuzumab in patient 3. Patient 1 presented with a cough and fever after the fourth cycle of trastuzumab. Patient 2 experienced rapid deterioration of oxygen saturation without subjective symptoms within 3 h of the first administration of trastuzumab. Patient 3 was unexpectedly diagnosed with organizing pneumonia in a scheduled computed tomography (CT) scan after the first course of trastuzumab. Based on clinical data, such as decreased PaO2level, increased serum levels of KL-6 and/or lactate dehydrogenase, and findings on chest CT, these patients were diagnosed with drug-induced ILD. Considering the clinical course, trastuzumab was incriminated as the cause of ILD, particularly in patients 1 and 2. All 3 patients improved due to the timely diagnosis, discontinuation of trastuzumab and immediate administration of corticosteroid therapy. Although ILD is a rare adverse event associated with trastuzumab, it may cause rapid deterioration without preceding symptoms. Close observation and early diagnosis are required to avoid an unfavorable outcome.
authors.affiliation: Department of Clinical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan; Department of Gastroenterology and Hepatology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Sugaya
authors.affiliation: Department of Clinical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Ishiguro
authors.affiliation: Department of Clinical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Mitsuhashi
authors.affiliation: Department of Pulmonary Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Pulmonary Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Ikuta
authors.initials: I
authors.lastname: Hashimoto
authors.affiliation: Department of Pulmonary Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kaburagi
authors.affiliation: Department of Clinical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan; Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Kasama, Ibaraki 309-1793, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kojima
keywords: breast cancer; case reports; interstitial lung disease; trastuzumab