Reactions 1351 - 14 May 2011

SAntineoplastics

Interstitial lung disease: 4 case reportsA retrospective study identified four patients who

developed interstitial lung disease during treatment withstandard chemotherapy with FOLFOX (fluorouracil +calcium levofolinate + oxaliplatin), FOLFIRI (fluorouracil +calcium levofolinate + irinotecan) or XELOX (capecitabine+ oxaliplatin) and bevacizumab for metastatic colorectalcancer [routes and dosages not stated].

A 58-year-old man, who had previously receivedFOLFOX + bevacizumab, started receiving FOLFIRI +bevacizumab. Five days after his last dose followingchemotherapy cycle 5, he presented with fever. A chest CTshowed ground-glass opacities and an organisingpneumonia pattern. The grade of ILD according to theCommon Terminology Criteria for Adverse Events (CTCAE)v3.0 was grade 3. He was treated with high-dosemethylprednisolone followed by prednisolone and hissymptoms improved. One month later, he received XELOX+ bevacizumab. On day 21 of therapy, he complained offever. A chest x-ray showed infiltration at the right upperlung. He received antibiotics, but his symptoms did notdisappear. He received steroid therapy and his symptomsimproved. He was diagnosed with ILD recurrence inducedby XELOX + bevacizumab.

A 70-year-old man, who had previously receivedFOLFOX + capecitabine, started receiving FOLFIRI +bevacizumab. Eight days after his last dose followingchemotherapy cycle 5, he presented with fever. A chest CTshowed ground-glass opacities and an acute interstitialpneumonia pattern. The grade of ILD according to theCTCAE v3.0 was grade 4. He was treated with high-dosemethylprednisolone followed by prednisolone and hissymptoms improved.

A 72-year-old man started receiving FOLFOX +bevacizumab. Two days after his last dose followingchemotherapy cycle 15, he presented with fever. A chestCT showed ground-glass opacities and an organisingpneumonia pattern. The grade of ILD according to theCTCAE v3.0 was grade 2. He was treated with high-dosemethylprednisolone followed by prednisolone and hissymptoms improved.

A 59-year-old man, who had previously received XELOX,started receiving FOLFOX + bevacizumab. Two days afterhis last dose following chemotherapy cycle 9, he presentedwith fever. A chest CT showed ground-glass opacities andan idiopathic pulmonary fibrosis pattern. The grade of ILDaccording to the CTCAE v3.0 was grade 3. He was treatedwith high-dose methylprednisolone followed byprednisolone and ciclosporin and his symptoms improved.Usui K, et al. Interstitial lung disease during chemotherapy combined withoxaliplatin and/or bevacizumab in advanced colorectal cancer patients. JapaneseJournal of Clinical Oncology 41: 498-502, No. 4, Apr 2011. Available from: URL:http://dx.doi.org/10.1093/jjco/hyr006 - Japan 803054186

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Reactions 14 May 2011 No. 13510114-9954/10/1351-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved