Evaluation of the Incidence of Gefitinib Induced Interstitial Lung Disease in Patients with Pulmonary Adenocarcinoma
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 4
Abstract
Gefitinib induced interstitial lung disease (ILD) is a potentially serious adverse effect that should be considered in patients treated with gefitinib who present with unexpected dyspnea. This single-institution retrospective study aims to determine the incidence, clinical presentation, management, and clinical outcome in patients diagnosed with gefitinib induced ILD during the time frame of January 2013- December 2016. Out of 340 patients with EGFR-mutated pulmonary adenocarcinoma who received gefitinib as targeted therapy against EGFR exon 19 or exon 21 mutations, 36 patients developed features confirmatory of ILD. The median time of presentation of ILD was after the 3rd month of gefitinib use. Eighteen patients (50%) presented with acute onset dyspnea, and dry cough and further eighteen patients (50%) presented with insidious onset of dry cough and dyspnoea. Infectious pneumonitis was not considered as interstitial lung disease. Six of these patients had severe ILD. Four of these patients responded to corticosteroid treatment and supplemental oxygen. One patient recovered after intensive care and mechanical ventilation and one patient succumbed to ILD despite mechanical ventilation. Incidence of mild and serious ILD in this Indian patient population was 8.8% & 1.8%, respectively. Thus, gefitinib induced lung disease is not uncommon and thus requires a high index of suspicion for early diagnosis and drug discontinuation.
Authors and Affiliations
Kailash Chandra Pandey, Swaroop Revannasiddaiah, Nirdosh Kumar Pant, Lalit Mohan, Madhup Rastogi
Keywords
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