Journal List > Tuberc Respir Dis > v.62(2) > 1001058

Ryu, Kim, Kim, Kim, Cho, Kwak, and Lee: Acute Respiratory Failure Developed in Non-small Cell Lung Cancer Patients Treated With Gefitinib

Abstract

Gefitinib is an oral selective inhibitor that targets the tyrosine kinase of the epidermal growth factor receptor. The prevalence of interstitial lung disease is 2% in Japan and 0.3% in the USA with a mortality rate of up to one third. We describe two non-small cell lung cancer patients who developed acute respiratory failure after gefitinib, and suggest that clinicians take extreme caution when deciding to treat patients with gefitinib.

Figures and Tables

Figure 1
Chest radiography shows newly developed pulmonary infiltrates on left lower lung field in case 1 and 2. Bilateral ground glass opacities are noted on chest CT scan of case 2.
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Figure 2
It demonstrates hyaline membranes lining the alveolar wall with edema and interstitial mononuclear cell infiltrate in case 1. Fibrinoid proteinaceous exudate in the alveolar space and sometimes along the alveolar walls and intra-alveolar and interstitial infiltration of neutrophils and lymphocytes are shown in case 2.
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Table 1
Summary of Death Cases from Respiratory Failure Induced by Gefitinib*
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*AD=adenocarcinoma, CTx=chemotherapy, DAD=diffuse alveolar damage, IPF=idiopathic pulmonary fibrosis, L=large cell carcinoma, NE=not evaluated, PY=pack-years, RTx=radiation therapy, SQ=squamous cell carcinoma, SD=stable disease, Clinical diagnosis=diagnosis made by clinical and radiologic findings; , response to gefitinib; , Period of administration of gefitinib before the development of acute respiratory failure; , post-radiation pulmonary fibrosis

Notes

This study was supported by INHA University Research Grant (INHA)

References

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Jae-Hwa Cho
https://orcid.org/http://orcid.org/0000-0002-3432-3997

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