Gocho Kyoko, Sato Kenya, Iizuka Noboru, Sunada Kouichi, Nishiya Shin, Hamanaka Nobuyuki
Department of Respiratory Medicine Saiseikai Yokohamashi Tobu Hospital Yokohama City Japan.
Department of Breast Surgery Saiseikai Yokohamashi Tobu Hospital Yokohama City Japan.
Respirol Case Rep. 2022 Mar 9;10(4):e0928. doi: 10.1002/rcr2.928. eCollection 2022 Apr.
Trastuzumab deruxtecan (T-DXd) frequently induces interstitial lung disease (ILD) more than other anti-human epidermal growth factor receptor 2 therapies. We diagnosed two cases of ILD induced by T-DXd in patients with advanced breast cancer. The first case is that of a 57-year-old Japanese woman who complained of dyspnoea and fever after 4 cycles of T-DXd. Chest computed tomography (CT) showed diffuse consolidation and a reticular shadow. The second case was that of a 72-year-old Japanese woman who complained of dyspnoea after 3 cycles of T-DXd. Chest CT showed a reticular shadow predominantly in the left lung. Both patients were treated with corticosteroids, including pulse methylprednisolone; however, their general condition weakened due to ILD, long-term corticosteroid therapy and breast cancer progression. Subsequently, the patients were unable to continue chemotherapy for breast cancer. To the best of our knowledge, this is the first report in a real-world clinical setting.
曲妥珠单抗德鲁昔单抗（T-DXd）比其他抗人表皮生长因子受体2疗法更常诱发间质性肺病（ILD）。我们诊断出两例晚期乳腺癌患者由T-DXd诱发的ILD。第一例是一名57岁的日本女性，在接受4个周期的T-DXd治疗后出现呼吸困难和发热。胸部计算机断层扫描（CT）显示弥漫性实变和网状阴影。第二例是一名72岁的日本女性，在接受3个周期的T-DXd治疗后出现呼吸困难。胸部CT显示主要在左肺有网状阴影。两名患者均接受了包括脉冲甲基强的松龙在内的皮质类固醇治疗；然而，由于ILD、长期皮质类固醇治疗和乳腺癌进展，她们的一般状况恶化。随后，患者无法继续进行乳腺癌化疗。据我们所知，这是真实临床环境中的首例报告。
