open access

Vol 18, No 6 (2022)
Case report
Published online: 2022-10-28
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Case report of radiation-induced lung injury with trastuzumab emtansine: the lung also matters

Ezgi Gurlek1, Melek Tugce Yilmaz1, Melis Gultekin1, Sercan Aksoy2, Ferah Yildiz1
DOI: 10.5603/OCP.2022.0043
·
Oncol Clin Pract 2022;18(6):415-419.
Affiliations
  1. Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
  2. Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

open access

Vol 18, No 6 (2022)
CASE REPORTS
Published online: 2022-10-28

Abstract

With an increase in the number of agents used concurrently with radiotherapy (RT), a new research area has emerged regarding toxicity. Here, we present a case of a 47-year-old woman presenting with radiation-induced lung injury (RILI) that occurred six months after the end of RT with concomitant and sequential use of trastuzumab-emtansine (T-DM1) with RT. The patient’s T-DM1 treatment was discontinued because of RILI. Antibiotic and methylprednisolone treatments were started. The steroid dose was gradually tapered and completely discontinued after full recovery. If new agents are used concurrently with RT, the toxicity profile of new agents should be kept in mind. 

Abstract

With an increase in the number of agents used concurrently with radiotherapy (RT), a new research area has emerged regarding toxicity. Here, we present a case of a 47-year-old woman presenting with radiation-induced lung injury (RILI) that occurred six months after the end of RT with concomitant and sequential use of trastuzumab-emtansine (T-DM1) with RT. The patient’s T-DM1 treatment was discontinued because of RILI. Antibiotic and methylprednisolone treatments were started. The steroid dose was gradually tapered and completely discontinued after full recovery. If new agents are used concurrently with RT, the toxicity profile of new agents should be kept in mind. 

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Keywords

breast cancer; trastuzumab emtansine; pneumonitis; radiotherapy

About this article
Title

Case report of radiation-induced lung injury with trastuzumab emtansine: the lung also matters

Journal

Oncology in Clinical Practice

Issue

Vol 18, No 6 (2022)

Article type

Case report

Pages

415-419

Published online

2022-10-28

Page views

536

Article views/downloads

61

DOI

10.5603/OCP.2022.0043

Bibliographic record

Oncol Clin Pract 2022;18(6):415-419.

Keywords

breast cancer
trastuzumab emtansine
pneumonitis
radiotherapy

Authors

Ezgi Gurlek
Melek Tugce Yilmaz
Melis Gultekin
Sercan Aksoy
Ferah Yildiz

References (20)
  1. Ahmed S, Sami A, Xiang J. HER2-directed therapy: current treatment options for HER2-positive breast cancer. Breast Cancer. 2015; 22(2): 101–116.
  2. Ross JS, Slodkowska EA, Symmans WF, et al. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist. 2009; 14(4): 320–368.
  3. Sodergren SC, Copson E, White A, et al. Systematic Review of the Side Effects Associated With Anti-HER2-Targeted Therapies Used in the Treatment of Breast Cancer, on Behalf of the EORTC Quality of Life Group. Target Oncol. 2016; 11(3): 277–292.
  4. Dhokarh R, Li G, Schmickl CN, et al. Drug-associated acute lung injury: a population-based cohort study. Chest. 2012; 142(4): 845–850.
  5. Libshitz HI, Southard ME. Complications of radiation therapy: the thorax. Semin Roentgenol. 1974; 9(1): 41–49.
  6. Choi YoW, Munden RF, Erasmus JJ, et al. Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis. Radiographics. 2004; 24(4): 985–97; discussion 998.
  7. Bledsoe TJ, Nath SK, Decker RH. Radiation Pneumonitis. Clin Chest Med. 2017; 38(2): 201–208.
  8. von Minckwitz G, Huang CS, Mano MS, et al. KATHERINE Investigators. Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. N Engl J Med. 2019; 380(7): 617–628.
  9. Hackshaw MD, Danysh HE, Singh J, et al. Incidence of pneumonitis/interstitial lung disease induced by HER2-targeting therapy for HER2-positive metastatic breast cancer. Breast Cancer Res Treat. 2020; 183(1): 23–39.
  10. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991; 21(1): 109–122.
  11. Amiri-Kordestani L, Blumenthal GM, Xu QC, et al. FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014; 20(17): 4436–4441.
  12. Wedam S, Fashoyin-Aje L, Gao X, et al. FDA Approval Summary: Ado-Trastuzumab Emtansine for the Adjuvant Treatment of HER2-positive Early Breast Cancer. Clin Cancer Res. 2020; 26(16): 4180–4185.
  13. Cardoso F, Kyriakides S, Ohno S, et al. ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019; 30(8): 1194–1220.
  14. Corbin KS, Breen WG, Strauss JB. Radiation dermatitis in patients treated with concurrent trastuzumab emtansine (T-DM1). Clin Transl Radiat Oncol. 2020; 24: 99–101.
  15. Hazra B, Ghosh S, Kumar A, et al. The prospective role of plant products in radiotherapy of cancer: a current overview. Front Pharmacol. 2011; 2: 94.
  16. Barginear MF, John V, Budman DR. Trastuzumab-DM1: a clinical update of the novel antibody-drug conjugate for HER2-overexpressing breast cancer. Mol Med. 2013; 18: 1473–1479.
  17. Lind P, Wennberg B, Gagliardi G, et al. Pulmonary complications following different radiotherapy techniques for breast cancer, and the association to irradiated lung volume and dose. Breast Cancer Res Treat. 2001; 68(3): 199–210.
  18. Ho AY, Ballangrud A, Li G, et al. Long-Term Pulmonary Outcomes of a Feasibility Study of Inverse-Planned, Multibeam Intensity Modulated Radiation Therapy in Node-Positive Breast Cancer Patients Receiving Regional Nodal Irradiation. Int J Radiat Oncol Biol Phys. 2019; 103(5): 1100–1108.
  19. Bellon JR, Tayob N, Yang DD, et al. Local Therapy Outcomes and Toxicity From the ATEMPT Trial (TBCRC 033): A Phase II Randomized Trial of Adjuvant Trastuzumab Emtansine Versus Paclitaxel in Combination With Trastuzumab in Women With Stage I HER2-Positive Breast Cancer. Int J Radiat Oncol Biol Phys. 2022; 113(1): 117–124.
  20. Mandal A, Singh P, Tandon S, et al. “Radiation Recall Phenomenon” with Novel Cytotoxic Agents: An Emerging Trend in the Last Decade. Indian Journal of Medical and Paediatric Oncology. 2021.

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