A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature. Issue 3 (May 2015)

• Record Type: Journal Article
• Authors: Genestreti, Giovenzio; Di Battista, Monica; Trisolini, Rocco; Denicolò, Fabio; Valli, Mirca; Lazzari-Agli, Luigi Arcangelo; Dal Piaz, Giorgia; De Biase, Dario; Bartolotti, Marco; Cavallo, Giovanna; Brandes, Alba A.
• Is Part Of: Tumori. Volume 101:Issue 3(2015)
• Page Start: e92
• Page End: e95
• Publication Date: 2015-05
• Subjects: Docetaxel -- Drug-induced toxicity -- Lung cancer -- Pulmonary injury; Cancer -- Periodicals; 616.994
• DOI: 10.5301/tj.5000275
• Languages: English
• ISSNs: 0300-8916

Abstract

Background: Pulmonary toxicity is a well-known complication observed with several anticancer drugs. Docetaxel, a taxane chemotherapy drug widely used in the treatment of many types of solid tumors including non-small cell lung cancer (NSCLC), rarely causes infiltrative pneumonitis. The exact mechanism by which docetaxel develops this side effect is not well understood; probably it is produced by type I and IV hypersensitivity responses. Here we describe 2 cases of infiltrative pneumonitis induced by docetaxel as second-line chemotherapy in advanced NSCLC. Materials and Methods: Two patients with advanced NSCLC were treated with weekly docetaxel as second-line chemotherapy. After 3 courses of chemotherapy, restaging computed tomography (CT) of the chest revealed bilateral diffuse ground-glass opacities with a peribronchial distribution possibly indicative of hypersensitivity pneumonitis. No evidence of pulmonary embolus or pleural effusion was found. Fiberoptic bronchoscopy showed normal bronchi without lymphangitis; biopsies showed interstitial fibrosis without tumor cells. Bronchial tissue laboratory tests for fungi or bacilli were negative. No malignant cells were found at bronchoalveolar lavage. The patients were given high-dose corticosteroid therapy with prednisone 0.7 mg per kilogram per day. Results: After 1 month of therapy, contrast-enhanced chest CT showed complete disappearance of the pulmonary changes in both patients. Spirometry and blood gas analysis revealed complete recovery of pulmonary function. The patients continued their oncological follow-up program. Conclusions: Pulmonary injury is a rare adverse event during docetaxel chemotherapy. Prompt treatment with high-dose corticosteroids is needed to avoid worsening of respiratory performance.