Cetuximab
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Reactions 1425 - 27 Oct 2012 S Cetuximab Interstitial pneumonia: 2 case reports Two men, aged 61 and 65 years, developed interstitial pneumonia during treatment with cetuximab. The younger man had mesopharynx squamous cell carcinoma, and the older man had tonsilar squamous cell carcinoma and oesophageal adenocarcinoma. They received cetuximab post-radiotherapy, comprising 6 cycles of 400mg with a 600mg loading dose in the younger man, and a last dose of 450mg in the older man [routes not stated; not all dosages stated]. They presented with fever, cough and shortness and breath 5 or 6 weeks after starting cetuximab, respectively; the younger man also had lung consolidation. Both men also had skin rashes consistent with cetuximab-associated skin toxicity. CT scanning revealed ground-glass changes in their lungs. The younger man developed chemotherapy-related febrile neutropenia and an Enterobacter cloacae infection at his percutaneous endoscopic gastrostomy site, and received cefepime and ertapenem. The older man developed nosocomial pyelonephritis, and received empiric ceftriaxone. The men received antibiotics and prednisone. Chest x- ray results for the younger man were almost normal 7 days after starting prednisone, and he was discharged 3 days later. The older man’s symptoms improved within 5 days after starting prednisone. However, he subsequently developed gastrointestinal bleeding, severe acute respiratory distress syndrome and multiple organ dysfunction syndrome, and died. Autopsy revealed bronchitis with diffuse alveolar dysfunction, lung metastases, thrombotic endocarditis of his mitral valve, and ischaemic infarction of his spleen, kidney, brain and heart [cause of death not stated]. Author comment: "[W]e report on two patients who acquired an interstitial pneumonia most likely caused by cetuximab, since these patients did not improve despite the initiation of antimicrobial treatment". Achermann Y, et al. A rare but severe pulmonary side effect of cetuximab in two patients. BMJ Case Reports 2012: [5 pages], 28 Jul 2012. Available from: URL: http://dx.doi.org/10.1136/bcr-03-2012-5973 - Switzerland 803079060 1 Reactions 27 Oct 2012 No. 1425 0114-9954/10/1425-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Cetuximab
Reactions 1425 - 27 Oct 2012
SCetuximab
Interstitial pneumonia: 2 case reportsTwo men, aged 61 and 65 years, developed interstitial
pneumonia during treatment with cetuximab.The younger man had mesopharynx squamous cell
carcinoma, and the older man had tonsilar squamous cellcarcinoma and oesophageal adenocarcinoma. Theyreceived cetuximab post-radiotherapy, comprising 6 cyclesof 400mg with a 600mg loading dose in the younger man,and a last dose of 450mg in the older man [routes notstated; not all dosages stated]. They presented with fever,cough and shortness and breath 5 or 6 weeks after startingcetuximab, respectively; the younger man also had lungconsolidation. Both men also had skin rashes consistentwith cetuximab-associated skin toxicity. CT scanningrevealed ground-glass changes in their lungs. The youngerman developed chemotherapy-related febrile neutropeniaand an Enterobacter cloacae infection at his percutaneousendoscopic gastrostomy site, and received cefepime andertapenem. The older man developed nosocomialpyelonephritis, and received empiric ceftriaxone.
The men received antibiotics and prednisone. Chest x-ray results for the younger man were almost normal 7 daysafter starting prednisone, and he was discharged 3 dayslater. The older man’s symptoms improved within 5 daysafter starting prednisone. However, he subsequentlydeveloped gastrointestinal bleeding, severe acuterespiratory distress syndrome and multiple organdysfunction syndrome, and died. Autopsy revealedbronchitis with diffuse alveolar dysfunction, lungmetastases, thrombotic endocarditis of his mitral valve, andischaemic infarction of his spleen, kidney, brain and heart[cause of death not stated].
Author comment: "[W]e report on two patients whoacquired an interstitial pneumonia most likely caused bycetuximab, since these patients did not improve despite theinitiation of antimicrobial treatment".Achermann Y, et al. A rare but severe pulmonary side effect of cetuximab in twopatients. BMJ Case Reports 2012: [5 pages], 28 Jul 2012. Available from: URL:http://dx.doi.org/10.1136/bcr-03-2012-5973 - Switzerland 803079060
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Reactions 27 Oct 2012 No. 14250114-9954/10/1425-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
