Paclitaxel
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Pneumonitis: case report A 64-year-old man developed pneumonitis during treatment with paclitaxel for adenocarcinoma of the gastroesophageal junction. The man presented with dysphagia and progressive weight loss from 3 months. Eventually, he was diagnosed with adenocarcinoma of the gastroesophageal junction. He thus received induction chemotherapy with docetaxel, fluorouracil and oxaliplatin for 4 months, and demonstrated near-complete radiographic response. Therefore, he started receiving definitive concurrent chemoradiation with radiosensitising paclitaxel [dosages and route not stated] along with carboplatin. Within 2 weeks of chemoradiation, he developed shortness of breath and progressive and non-productive cough. A chest CT-scan demonstrated new bilateral pleural effusions and symmetric alveolar infiltrates with interlobular septal thickening. Eventually, he was diagnosed with paclitaxel-induced pneumonitis. The man’s treatment with paclitaxel and carboplatin was therefore stopped. He started receiving prednisone for the pneumonitis, which showed transient symptomatic improvement. However, his respiratory status deteriorated over the next 2 weeks. Eventually, he was hospitalised. He developed hypoxic respiratory failure requiring intubation. An extensive infectious work-up including bronchoscopy was insignificant. A chest CT-scan revealed worsening infiltrates. Despite high-dose prednisone, his respiratory status deteriorated (lack of efficacy). Thus, etanercept was initiated. He showed improvement, and 3 days after the first dose of etanercept, he was successfully extubated. His oxygen requirements diminished steadily over the next month. At 6 months postdischarge, a repeat chest CT-scan demonstrated improving interstitial thickening. Singavi AK, et al. Etanercept for Treatment of Taxane-Induced Pneumonitis. Journal of Oncology Practice 15: 556-557, No. 10, 01 Oct 2019. Available from: URL: http:// doi.org/10.1200/JOP.19.00180 803500277
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Reactions 12 Sep 2020 No. 1821
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