Acceleration of interstitial lung disease induced by raltitrexed. (July 2020)

• Record Type: Journal Article
• Authors: Howlett, Sarah; Aul, Raminder; Hill, Mark; Pinato, David J
• Is Part Of: Journal of oncology pharmacy practice. Volume 26:Number 5(2020)
• Page Start: 1241
• Page End: 1243
• Publication Date: 2020-07
• Subjects: Raltitrexed -- pulmonary toxicity -- colorectal carcinoma; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155219887213
• Languages: English
• ISSNs: 1078-1552

Abstract

Introduction: Raltitrexed is a folate analogue, which selectively inhibits thymidylate synthase, used in the treatment of colorectal carcinoma. Common side effects include asthenia and gastrointestinal and haematological toxicities. Case report: We present the case of a 74-year-old gentleman with incidental mild interstitial lung disease on preoperative staging CT Chest who developed acute breathlessness whilst undergoing adjuvant raltitrexed treatment for a completely excised colorectal adenocarcinoma. Management and outcome: Discontinuation of raltitrexed and a course of steroid therapy resulted in resolution of symptoms, mirrored by an improvement in lung function tests. Discussion: The clinical pattern of rapid progression with steroid response highlights the potential for significant acceleration of interstitial lung disease by raltitrexed.