A Case of Interstitial Pneumonitis Associated with Guillain-Barré Syndrome during Administration of Adjuvant Trastuzumab

Abstract

Optimal treatment for HER2/neu-positive, node-positive early breast cancer should include the monoclonal antibody trastuzumab. This relatively new agent has shown very limited pulmonary toxicity. Our report describes a case of life-threatening interstitial pneumonitis associated with Guillain-Barré syndrome that occurred during the administration of adjuvant trastuzumab. The severity of the clinical presentation and the limited number of reports in the literature of acute trastuzumab-related lung injury make the description of this case of crucial interest.

Pulmonary toxicities of biologics: a review

“…Altogether, the reports of apparent trastuzumab-related pulmonary interstitial disease in B-31, N9831, and four other reports [55,[64][65][66] are highly suggestive that this syndrome is a rare, but real, complication of this therapy. In one case, the patient subsequently developed Guillian-Barre syndrome [66].…”

“…In one case, the patient subsequently developed Guillian-Barre syndrome [66]. Clinicians should be aware of it and be prepared to respond appropriately, including discontinuation of further treatment or cautious coadministration with corticosteroids [64].…”

Interstitial lung disease associated with trastuzumab monotherapy: A report of 3 cases

“…Those case reports mostly concluded that paclitaxel or docetaxel, rather than trastuzumab, was responsible for the development of ILD, as ILD is a well-known complication of taxanes. However, according to our literature survey, there have been 4 English-language case reports of trastuzumab monotherapy-associated ILD (10)(11)(12)(13). Those cases and the 3 cases presented herein are summarized in Table I.…”

Is the interstitial lung disease induced by trastuzumab? Case report and literature review

“…5 Cases of subacute interstitial lung disease (ILD), organizing pneumonia and acute respiratory distress syndrome, have been reported in patients on trastuzumab treatment (incidence ≤1%). [6][7][8] Taxaneinduced pneumonitis has also been reported in a few case reports, with an incidence rate of about 5%. 9 Although the pulmonary toxicity induced by trastuzumab is rare, it can be life-threatening.…”