A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature

Genestreti, Giovenzio; M, Di Battista; Trisolini, Rocco; Denicolò, F; Valli, M.; La, Lazzari-Agli; Dalpiaz, Giorgia; Biase, Dario de; Bartolotti, Marco; Cavallo, Giovanna; Brandes, Alba A.

doi:10.5301/tj.5000275

Cited by 20 publications

(20 citation statements)

References 12 publications

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“…Pulmonary toxicity in these cases does not take the form of an acute hypersensitivity reaction but rather has a more interstitial lung disease (ILD)-type presentation characterized by increasing dyspnoea, dry cough, fever and bilateral pulmonary interstitial infiltrates. 6,[8][9][10] The mechanism behind this second type of pulmonary toxicity has been attributed to a type IV T-cell-mediated delayed hypersensitivity reaction. [9][10][11] Some patients have mild disease without hypoxia that responds quickly to therapy, while others develop hypoxia and can progress rapidly to respiratory failure.…”

Section: Taxanes Presentation/incidencementioning

confidence: 99%

“…5,7,15,26 Reticular opacities, thickened septal lines and irregular airspace consolidations consistent with non-specific interstitial pneumonitis (NSIP) or organizing pneumonia (OP) have also been described. 5,8,15 Some patients also present with diffuse GGO, consolidations and traction bronchiectasis consistent with diffuse alveolar damage. 7 Lung biopsy is not usually necessary to establish a diagnosis of taxane-induced pneumonitis; however, several case reports have described the pathological findings of patients presenting with severe taxane-induced pneumonitis.…”

Section: Radiographic and Histologic Featuresmentioning

confidence: 99%

“…Some patients respond quickly to cessation of taxane therapy and high-dose steroid treatment. 8,15,19,20 Unfortunately, some patients develop progressive respiratory failure despite steroid treatment requiring intubation and mechanical ventilation. Fatal cases of taxane-induced pneumonitis, although rare, have been reported in several case series and clinical trials.…”

Section: Radiographic and Histologic Featuresmentioning

confidence: 99%

“…Pulmonary toxicity has also been described with docetaxel and newer formulations of paclitaxel, including nanoparticle albumin‐bound paclitaxel (nab‐paclitaxel), 7 which are not formulated with the same diluent. Pulmonary toxicity in these cases does not take the form of an acute hypersensitivity reaction but rather has a more interstitial lung disease (ILD)‐type presentation characterized by increasing dyspnoea, dry cough, fever and bilateral pulmonary interstitial infiltrates 6,8–10 . The mechanism behind this second type of pulmonary toxicity has been attributed to a type IV T‐cell‐mediated delayed hypersensitivity reaction 9–11 .…”

Section: Taxanesmentioning

confidence: 99%

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Pulmonary toxicity of systemic lung cancer therapy

Long

Suresh

2020

Respirology

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Lung cancer is the leading cause of cancer-related deaths worldwide. As new therapies are developed, it is important to understand the pulmonary toxicities associated with systemic lung cancer therapies. Cytotoxic chemotherapy regimens for NSCLC often include taxanes. Pulmonary toxicity from taxanes presents as an ILD-type reaction characterized by increasing dyspnoea, dry cough, fever and bilateral pulmonary interstitial infiltrates. The incidence of taxane-induced pneumonitis is rare, and many patients respond to steroid therapy; however, fatal cases have been reported. Patients with NSCLC are routinely tested for the presence of tumour oncogenes to determine their candidacy for targeted therapies, such as TKI. EGFR-TKI can cause pneumonitis characterized by progressive dyspnoea and hypoxia. EGFR-TKIassociated ILD rarely presents as an AIP with rapidly progressive respiratory failure and high mortality rates. The most recent development in lung cancer therapy has been the discovery of immune checkpoint inhibitor (ICI). ICI pneumonitis has been increasingly recognized as a common complication of ICI therapy, with reported incidence as high as 19% in some clinical settings. Early-grade ICI pneumonitis may be asymptomatic; however, high-grade ICI pneumonitis can result in progressive dyspnoea, hypoxia and respiratory failure. ICI pneumonitis is unique in that only half of the patients will improve with steroid treatment, and mortality rates are high. As treatment of NSCLC evolves, providers must be able to recognize and respond to the development of drug-induced pulmonary toxicities.

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Section: Taxanes Presentation/incidencementioning

confidence: 99%

Section: Radiographic and Histologic Featuresmentioning

confidence: 99%

Section: Radiographic and Histologic Featuresmentioning

confidence: 99%

Section: Taxanesmentioning

confidence: 99%

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Pulmonary toxicity of systemic lung cancer therapy

Long

Suresh

2020

Respirology

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“…Pneumonitis is a rare but serious (potentially lethal) complication of docetaxel therapy 53 . This issue is more pressing at the current time, as docetaxel is frequently used in the castrate‐sensitive setting.…”

Section: Resultsmentioning

confidence: 99%

Optimizing the management of castration‐resistant prostate cancer patients: A practical guide for clinicians

et al. 2020

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Background Advanced prostate cancer (PC) patients, especially those with metastatic prostate cancer (mPC), often require complex management pathways. Despite the publication of clinical practice guidelines by leading urological and oncological organizations that provide a substantial and comprehensive framework, there are numerous clinical scenarios that are not always addressed, especially as new treatments become available, new imaging modalities are developed, and advances in genetic testing continue. Methods A 14‐member expert review panel comprised of urologists and medical oncologists were chosen to provide guidance on addressing specific topics and issues regarding metastatic castration‐resistant prostate cancer (mCRPC) patients. Panel members were chosen based upon their experience and expertise in the management of PC patients. Four academic members (two urologists and two medical oncologists) of the panel served as group leaders; the remaining eight panel members were from Large Urology Group Practice Association (LUGPA) practices with proven experience in leading their advanced PC clinics. The panel members were assigned to four separate working groups, each assigned a specific mCRPC topic to review and discuss with the entire panel. Results This article describes the practical recommendations of an expert panel on the management of mCRPC patients. The target reading audience for this publication is all providers (urologists, medical oncologists, radiation oncologists, or advanced practice providers) who evaluate and manage advanced PC patients, regardless of their practice setting. Conclusion The panel has provided recommendations for managing mCRPC with regard to specific issues: (a) biomarker monitoring and the role of genetic and molecular testing; (b) rationale, current strategies, and optimal sequencing of the various approved therapies, including hormonal therapy, cytotoxic chemotherapy, radiopharmaceuticals and immunotherapy; (c) adverse event management and monitoring; and (d) imaging advanced PC patients. These recommendations seek to complement national guidelines, not replace them, and a discussion of where the panel agreed or disagreed with national guidelines is included.

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Immune‐related adverse events and outcomes among pan‐cancer patients receiving immune checkpoint inhibitors: A monocentric real‐world observational study

Jiang

et al. 2023

Cancer Medicine

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BackgroundReal‐world evidence on immune‐related adverse events (irAEs) are relatively insufficient. Herein patterns and outcomes of irAEs after administration of anti‐programmed cell death 1 (PD‐1) and its legend 1 (PD‐L1) antibodies were investigated.MethodsPatients treated with anti‐PD‐1/PD‐L1 drugs from January 2018 to September 2021 at Huadong Hospital, Fudan University were included. Common Terminology Criteria for Adverse Events (CTCAE) was used for irAEs evaluation. The primary endpoints were the clinical description of irAEs.ResultsTwo hundred and forty‐one solid tumor patients were included, with lung cancer as the most common tumor type (56%). 187 (77.6%) patients presented any kind of irAEs. The median time to any irAE onset was 28 (95% CI 24–32) days. Skin toxicities are the most common irAEs (46.1%) and the irAEs (36.5%) occurred earliest after immune‐checkpoint inhibitors. The most frequently occurred all‐grade irAEs were rash (23.7%), myelosuppression (20.7%), and hepatic injury (19.5%). 23 (9.5%) patients died of severe irAEs, which consists of 10 patients with pneumonitis, four colitis, four myocarditis, and one each for gastritis, pulmonary embolism, myelosuppression, hypophysitis, and encephalitis. Patients with any irAE onset had significantly longer progression‐free survival (PFS) (p = 0.013) and overall survival (OS) (p = 0.007), respectively, than patients without irAEs. In addition, patients with skin toxicities (p = 0.012) or blood toxicities (p = 0.015) had achieved a longer PFS, than those without corresponding toxitities, respectively.ConclusionMost irAEs are mild and manageable, while some irAEs can present at later time or can be life‐threatening, especially pneumonitis as we observed. Patients with any irAE onset may achieve a better prognosis than those without irAEs, and presentation of skin or blood toxicities will indicate a better PFS.

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A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature

Abstract: Pulmonary injury is a rare adverse event during docetaxel chemotherapy. Prompt treatment with high-dose corticosteroids is needed to avoid worsening of respiratory performance.

Cited by 20 publications

References 12 publications

Pulmonary toxicity of systemic lung cancer therapy

Pulmonary toxicity of systemic lung cancer therapy

Optimizing the management of castration‐resistant prostate cancer patients: A practical guide for clinicians

Immune‐related adverse events and outcomes among pan‐cancer patients receiving immune checkpoint inhibitors: A monocentric real‐world observational study

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