Interstitial Pneumonia Possibly Due to a Novel Anticancer Drug, TS-1: First Case Report

Kurakawa, Eri; Kasuga, Ikuma; Ishizuka, Shirou; Yoshida, Tsuyoshi; Kunisawa, Akira; Minemura, Kazushige; Utsumi, Kenta; Ohyashiki, Kazuma

doi:10.1093/jjco/hye057

Cited by 15 publications

(4 citation statements)

References 3 publications

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“…To our knowledge, this is the rst study to identify risk factors for second-line chemotherapy-related AE-ILD. Although S-1 and 5-uorouracil (5-FU) have been widely used for the treatment of various cancers in Japan and other Asian countries (including gastrointestinal, breast, and pancreatic cancers) [24][25][26][27], there are only a few reported cases of S-1-and 5-FU-induced ILD [28][29][30][31]. This suggests that S-1, a prodrug of 5-FU, rarely causes ILD.…”

Section: Discussionmentioning

confidence: 99%

Real-world evaluation of second line chemotherapy for patients with advanced non-small cell lung cancer harboring preexisting interstitial lung disease

et al. 2021

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Background: The optimal second and subsequent lines of chemotherapy for patients with non-small cell lung cancer (NSCLC) who have preexisting interstitial lung disease (ILD) are unclear. Hence, we examined the clinical e cacy and safety of second-line chemotherapy in such patients, including any exacerbation of preexisting ILD. Methods: The medical records of patients with NSCLC and preexisting ILD who received both rst-and second-line chemotherapy were retrospectively reviewed.Results: Twenty-four patients with a median age of 71 years who were treated between April 2013 and March 2021 were included. The response rate after second-line chemotherapy with S-1 (n=13), docetaxel (n=8), pemetrexed (n=2), or docetaxel plus ramucirumab (n=1) was 12.5%, with a median progression-free survival (2 nd line PFS) of 3.8 months. The overall survival from a start of rst-line chemotherapy (1 st line OS) and post-progression survival (PPS) post-rst-line chemotherapy were 18.7 and 9.7 months, respectively. Spearman rank correlation and linear regression analyses showed that PPS was strongly correlated with 1 st line OS (R = 0.85, P < 0.00001). Importantly, the 2 nd line PFS was also signi cantly correlated with 1 st line OS (R = 0.71, P = 0.0001). While second-line chemotherapy-related acute exacerbation of ILD was observed in 7 patients (29.2%), there were no treatment-related fatalities.Conclusions: Second-line chemotherapy has a strong positive impact on the OS of patients with NSCLC who have preexisting ILD. Given the ndings of this study, second-line chemotherapy may be valuable in terms of prolonging long-term OS.

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Section: Discussionmentioning

confidence: 99%

Real-world evaluation of second line chemotherapy for patients with advanced non-small cell lung cancer harboring preexisting interstitial lung disease

et al. 2021

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“…Several severe adverse reactions caused by TS‐1 have been reported. For instance, interstitial pneumonia caused by TS‐1, a serious complication, was first reported by Kurakawa in 2001, 16 followed by several articles on interstitial pneumonia induced by TS‐1, 17,18 suggesting that the quantitative risk of TS‐1 should be taken into account. Several reports reflect the potential risk of TS‐1 to patients, including a 44‐year‐old woman and a 66‐year‐old man with gastric cancer who developed acral lentiginosis associated with oral TS‐1 19 .…”

Section: Discussionmentioning

confidence: 99%

Stevens–Johnson syndrome associated with TS‐1 in a patient with gastric cancer: A case report

Wang

2020

Brit J Clinical Pharma

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TS‐1, an effective anticancer drug that consists of tegafur, gimeracil and oteracil, has been increasingly used for the treatment of many types of cancer. However, few studies investigate its cutaneous adverse reactions. Here, we report a female patient with gastric cancer treated with TS‐1 after a gastrectomy, who then developed Stevens–Johnson syndrome, a cutaneous and potentially life‐threatening adverse reaction. This is the first case report about a Grade IV toxic reaction associated with TS‐1. The patient presented with systemic symptoms of erythematous macules, vesicle formation, erosions, binocular ptosis and oedema of the lower eyelid conjunctiva. After 3 weeks of hospitalization with drug treatment and discontinuation of TS‐1, her symptoms were fully relieved and did not recur because the chemotherapy regimen was adjusted to modified FOLFOX6. According to the comprehensive analysis and the score of both the Naranjo assessment scale and algorithm of drug causality for epidermal necrolysis, we have drawn the preliminary conclusion that this is TS‐1‐induced Stevens–Johnson syndrome.

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“…There has been only one report of ILD induced by TS-1 in patients with gastric cancer [8]. ILD was aggravated after the start of treatment with TS-1 within 1 month.…”

Section: Discussionmentioning

confidence: 99%

Interstitial lung disease caused by TS-1: a case of long-term drug retention as a fatal adverse reaction

et al. 2011

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TS-1 is an oral anti-cancer agent for gastric cancer with a high response rate and low toxicity. We report a case of long-term drug retention of TS-1 causing interstitial lung disease (ILD) as a fatal adverse reaction. A 65-year-old woman underwent a total gastrectomy with pathologic confirmation of gastric adenocarcinoma. She received 6 cycles of TS-1 and low-dose cisplatin for post-operative adjuvant chemotherapy followed by single-agent maintenance therapy with TS-1. After 8 months, the patient complained of a productive cough with sputum and mild dyspnea. A pulmonary evaluation revealed diffuse ILD in the lung fields, bilaterally. In spite of discontinuing chemotherapy and the administration of corticosteroids, the pulmonary symptoms did not improve, and the patient died of pulmonary failure. TS-1-induced ILD can be caused by long-term drug retention that alters the lung parenchyma irreversibly, the outcome of which can be life-threatening. Pulmonary evaluation for early detection of disease is recommended.

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Interstitial Pneumonia Possibly Due to a Novel Anticancer Drug, TS-1: First Case Report

Cited by 15 publications

References 3 publications

Real-world evaluation of second line chemotherapy for patients with advanced non-small cell lung cancer harboring preexisting interstitial lung disease

Real-world evaluation of second line chemotherapy for patients with advanced non-small cell lung cancer harboring preexisting interstitial lung disease

Stevens–Johnson syndrome associated with TS‐1 in a patient with gastric cancer: A case report

Interstitial lung disease caused by TS-1: a case of long-term drug retention as a fatal adverse reaction

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