Interstitial pneumonitis related to flutamide monotherapy for prostate cancer

Abstract

A 88-year-old man with prostate cancer was receiving non-steroidal anti-androgen therapy (flutamide, 375 mg/day). Three weeks after starting therapy, the patient developed dyspnea and bilateral pulmonary interstitial infiltrates. The withdrawal of flutamide and the initiation of steroid therapy resulted in clinical improvement.

Lung caught in Nilutamide treatment

“…Nilutamide is a non-steroidal antiandrogen, which competitively inhibits the binding of androgens to the androgen receptor 1. Interstitial pneumonitis is an extremely rare, although reversible, adverse reaction to non-steroidal antiandrogen treatment, being described in 1–2% of the patients taking the drug 2. The mechanisms by which non-steroidal antiandrogens cause pulmonary disease remain unclear 3…”

“…The onset of symptoms was reported 2–8 months after the beginning of the treatment 2. The prognosis of drug-induced pneumonitis is relatively good and can be treated with the withdrawal of the drug with or without the association of steroids 3…”