Patterns of interstitial lung disease during everolimus treatment in patients with metastatic renal cell carcinoma

Ryuichi Mizuno, Koichiro Asano, Shuji Mikami, Hirohiko Nagata, Gou Kaneko, Mototsugu Oya

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: To elucidate the patterns of interstitial lung disease during everolimus treatment in patients with metastatic renal cell carcinoma, we reviewed seven cases of everolimus-induced interstitial lung disease. Methods: Seven patients with metastatic renal cell carcinoma, which continued to progress despite treatment with sunitinib or sorafenib, developed interstitial lung disease after treatment with everolimus. Results: Chest X-ray demonstrated diffuse infiltrates in lung fields, and chest computed tomography showed bilateral reticular and ground-glass opacities. Serum levels of lactate dehydrogenase (7/7), C-reactive protein (6/7), pulmonary surfactant associated protein D (1/7) and Krebs von den Lungen 6 (5/7) were elevated. The bronchoalveolar lavage fluid obtained from four patients with Grade 3 interstitial lung disease showed lymphocytosis. The transbronchial lung biopsy specimens showed interstitial lymphocytic infiltration and septal thickening of alveolar walls. In two cases with mild interstitial lung disease, the everolimus therapy was successfully continued. In four cases with Grade 3 interstitial lung disease, the drug was discontinued and steroid therapy was initiated. Pulmonary symptoms and radiological abnormalities resolved within 2 months. Conclusions: Serum Krebs von den Lungen 6 was elevated compared with baseline in all cases with interstitial lung disease. Some patients who developed mild interstitial lung disease during everolimus treatment could continue to receive the treatment. Even when severe interstitial lung disease developed, withdrawal of the drug and short-term use of high-dose steroids resulted in rapid recovery. Prompt recognition of interstitial lung disease exacerbation as well as exclusion of progressive disease or infection is of primary importance.

Original languageEnglish
Article numberhys033
Pages (from-to)442-446
Number of pages5
JournalJapanese Journal of Clinical Oncology
Volume42
Issue number5
DOIs
Publication statusPublished - 2012 May

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Interstitial Lung Diseases
Renal Cell Carcinoma
Therapeutics
Lung
Thorax
Steroids
Everolimus
Pulmonary Surfactant-Associated Protein D
Lymphocytosis
Bronchoalveolar Lavage Fluid
Serum
L-Lactate Dehydrogenase
Pharmaceutical Preparations
C-Reactive Protein
Glass
Disease Progression
Tomography
X-Rays
Biopsy

Keywords

  • Everolimus
  • Interstitial lung disease
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Radiology Nuclear Medicine and imaging

Cite this

Patterns of interstitial lung disease during everolimus treatment in patients with metastatic renal cell carcinoma. / Mizuno, Ryuichi; Asano, Koichiro; Mikami, Shuji; Nagata, Hirohiko; Kaneko, Gou; Oya, Mototsugu.

In: Japanese Journal of Clinical Oncology, Vol. 42, No. 5, hys033, 05.2012, p. 442-446.

Research output: Contribution to journalArticle

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