Gefitinib-induced interstitial lung disease showing improvement after cessation: disassociation of serum markers.

Abstract

Gefitinib (ZD1839), a small-molecule epidermal growth factor receptor tyrosine kinase inhibitor, is an anticancer agent for patients with non-small cell lung carcinoma. Recently, however, as a result of accumulating evidence, it has been recognized that gefitinib can give rise to lethal lung toxicity. The authors report a case of interstitial lung disease (ILD) induced by gefitinib, which improved promptly following cessation of the administration of the agent. Clinical signs suggesting a good prognosis were noted, namely, findings similar to acute eosinophilic pneumonia on CT and a disassociation in the elevation of specific serum markers of ILD. At the time of onset of ILD, serum concentrations of surfactant protein (SP)-A and SP-D were significantly increased, whereas that of KL-6 was not increased. A previous study of three cases of lethal lung toxicity resulting from gefitinib administration revealed a significant and almost equal increase in KL-6, SP-A and SP-D. These results suggest that SP-A and SP-D may be indicators of gefitinib-induced ILD and that KL-6 is a predictor of outcome. Using a combination of these markers may help to establish a differential prognosis in patients with gefitinib-induced ILD.

• Authors: Hiroko Kitajima, Hiroki Takahashi, Kazutoki Harada, Akiko Kanai, Shin-Ichiro Inomata, Haruko Taniguchi, Toyohiro Saikai, Shosaku Abe
• Journal: Respirology (Carlton, Vic.) (Respirology) Vol. 11 Issue 2 Pg. 217-20 (Mar 2006) ISSN: 1323-7799 [Print] Australia
• PMID: 16548909 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antigens, Neoplasm
• Antineoplastic Agents
• Biomarkers
• MUC1 protein, human
• Mucin-1
• Mucins
• Pulmonary Surfactant-Associated Protein A
• Pulmonary Surfactant-Associated Protein D
• Quinazolines
• Gefitinib

Topics

• Adenocarcinoma (drug therapy, pathology)
• Antigens, Neoplasm (blood)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Biomarkers (blood)
• Biopsy
• Female
• Gefitinib
• Humans
• Lung Diseases, Interstitial (blood, chemically induced, diagnosis)
• Lung Neoplasms (drug therapy, pathology)
• Middle Aged
• Mucin-1
• Mucins (blood)
• Pulmonary Surfactant-Associated Protein A (blood)
• Pulmonary Surfactant-Associated Protein D (blood)
• Quinazolines (adverse effects, therapeutic use)
• Tomography, X-Ray Computed