Errisuriz Kimberly, Bazan Daniela Z, Verduzco Rene, Guedez Rosa
School of Pharmacy, Texas A&M Health Science Center, Kingsville, USA.
Pharmacy, Doctors Hospital at Renaissance, Edinburg, USA.
Cureus. 2023 Jul 19;15(7):e42116. doi: 10.7759/cureus.42116. eCollection 2023 Jul.
Trastuzumab is a recombinant immunoglobulin G1 monoclonal antibody used to treat human epidermal growth factor receptor 2 (HER2) cancers. Trastuzumab-induced interstitial pneumonitis is a rare adverse effect reported in a few patients. Interstitial pneumonitis presents as symptoms of dyspnea, hypoxia, cough, and fever. If the patient is treated early, corticosteroids can slow or reverse the disease progression. A 41-year-old woman presented with dyspnea and a dry cough three weeks after her third cycle of trastuzumab therapy for breast cancer. A diagnosis of trastuzumab-induced interstitial pneumonitis was made after multiple other disease processes were ruled out. The patient was started on methylprednisolone while inpatient and transitioned to prednisone for outpatient therapy. The patient was maintained on 2-3L of oxygen throughout her hospital stay and was discharged on 3L of oxygen through nasal cannula. Trastuzumab was never restarted after discharge. There have been many trials evaluating the safety, efficacy, and optimal treatment regimen of trastuzumab, but there are only a few reports of interstitial pneumonitis adverse reaction. The lack of correlation and limited cases make this adverse effect very difficult to diagnose and monitor. New trials and case reports can bring an insight into contributing factors, symptoms at onset, and treatment for future patients. With the increase in use of trastuzumab therapy, physicians should be aware of how to diagnose and treat the rare adverse reaction of trastuzumab-induced interstitial pneumonitis.
曲妥珠单抗是一种重组免疫球蛋白G1单克隆抗体，用于治疗人表皮生长因子受体2（HER2）相关癌症。曲妥珠单抗诱发的间质性肺炎是少数患者中报道的一种罕见不良反应。间质性肺炎表现为呼吸困难、缺氧、咳嗽和发热等症状。如果患者得到早期治疗，皮质类固醇可以减缓或逆转疾病进展。一名41岁女性在接受乳腺癌曲妥珠单抗治疗的第三个周期后三周出现呼吸困难和干咳。在排除了多种其他疾病过程后，诊断为曲妥珠单抗诱发的间质性肺炎。患者住院期间开始使用甲泼尼龙治疗，出院后转为泼尼松进行门诊治疗。患者在整个住院期间持续吸氧2 - 3升，出院时通过鼻导管吸氧3升。出院后曲妥珠单抗从未重新使用。已经有许多试验评估曲妥珠单抗的安全性、疗效和最佳治疗方案，但关于间质性肺炎不良反应的报道却很少。缺乏相关性以及病例有限使得这种不良反应非常难以诊断和监测。新的试验和病例报告可以为未来患者的促成因素、发病症状和治疗提供见解。随着曲妥珠单抗治疗使用的增加，医生应该了解如何诊断和治疗曲妥珠单抗诱发的间质性肺炎这种罕见不良反应。
