Successful treatment of gefitinib-induced acute interstitial pneumonitis with high-dose corticosteroid: a case report and literature review
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Li-Chiao Kuo • Po-Chou Lin • Ko-Fan Wang • Mei-Kang Yuan • Shih-Chieh Chang
- چاپ و سال / کشور: 2010
Description
Cytotoxic chemotherapy offers a modest benefit for patients with advanced non-small cell lung cancer (NSCLC), with response rates of 20–35% and median survival of 10–12 months. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), gefitinib and erlotinib are active against lung cancer. In retrospective studies, EGFR-TKI therapy among patients harboring EGFR mutations showed response rates higher than 65% and a median survival of 20–30 months. Gefitinib is well tolerated and less toxic compared to conventional cytotoxic drugs, but gefitinib-related interstitial lung disease (ILD) has been reported as a serious adverse effect. Although the mechanism remains unknown, multivariate analysis revealed male sex, history of smoking, and the coexistence of interstitial pneumonia or pre-existence of pulmonary fibrosis and poor performance status were all significant risk factors. Here, we reported a case of gefitinib pneumonitis with severe hypoxemia and impending respiratory failure who showed poor response to intermediate dose of systemic steroids but good recovery with high-dose pulse therapy.
Med Oncol (2011) 28:79–82 DOI 10.1007/s12032-010-9424-4 Received: 30 December 2009 / Accepted: 7 January 2010 / Published online: 20 January 2010
