Fibrotic lung toxicity induced by cytotoxic drugs, radiation and immunotherapy in patients treated for lung cancer

Bargagli, Elena; Bonti, Viola; Bindi, Alessandra; Scotti, Vieri; Voltolini, Luca; Ferrari, Katia

doi:10.4081/monaldi.2018.917

Cited by 7 publications

(6 citation statements)

References 20 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the treatment for RIOP is corticosteroids, which can provide rapid relief of symptoms, interestingly, corticosteroids were associated with an increased relapse rate of RIOP compared to nonsteroidal medications, such as nonsteroidal anti-inflammatory drugs, antibiotics, or antitussives, in a single-institution retrospective study [22]. Lung injury from chemotherapy, RT, or radiation recall should not be taken lightly, as severe cases can lead to death [32].…”

Section: Discussionmentioning

confidence: 99%

Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report

et al. 2020

View full text Add to dashboard Cite

Radiation recall dermatitis (RRD) is a rare complication that occurs after completion of radiation therapy (RT) and initiation of a precipitating agent, most commonly chemotherapeutic medications. Various theories attempt to explain the mechanism, including activation of the body's inflammatory pathways through nonimmune activation. Likewise, radiation-induced organizing pneumonia (RIOP) is an infrequent but potentially life-threatening complication of RT that, while not fully understood, is suspected to be partly an autoimmune reaction. Patient: We present the case of a 71-year-old female with a history of type 2 diabetes mellitus, hypothyroidism, interstitial cystitis, and osteoarthritis who presented with clinical stage T1N0M0 ER+/PR-/HER2-invasive ductal carcinoma of the lower outer quadrant of the left breast, for which she underwent left segmental mastectomy and sentinel lymph node biopsy followed by completion axillary lymph node dissection. Her final pathologic stage was T1N1M0. Result: The patient developed RRD and later RIOP following receipt of radiation and chemotherapy, which resolved with steroid administration. Conclusions: The rarity of both RRD and RIOP occurring in a patient, as in our case, suggests a shared pathophysiology behind these two complications. As both reactions involve some degree of inflammation and respond to corticosteroids, it seems likely that the etiologies of RRD and RIOP lie within the inflammatory pathway. However, further investigation should evaluate the frequency, duration, and triggering of concomitant RRD and RIOP.

show abstract

Section: Discussionmentioning

confidence: 99%

Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Nonspecific interstitial pneumonitis (NSIP) and diffuse alveolar damage (DAD) are additional patterns of lung toxicity associated with cancer immunotherapy [34][35][36][37][38][39]41]. Nonspecific interstitial pneumonitis is a rare ILD.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

“…Other reported histological and radiological patterns are "diffuse alveolar hemorrhage (DAH)'' [8,[42][43], "hypersensitivity pneumonitis (HP)'' [8,34,36], "acute interstitial pneumonitis (AIP)'' [8,[36][37][38], "acute respiratory distress syndrome (ARDS)'' [8,39], "pulmonary fibrosis (PF)'' [8,[48][49] and radiation recall pneumonitis [50][51].…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

Pulmonary adverse events due to immune checkpoint inhibitors: A literature review

Georgakopoulou

Garmpis

Mermigkis

et al. 2021

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Cancer immunotherapy aims to stimulate the immune system to fight against tumors, utilizing the presentation of molecules on the surface of the malignant cells that can be recognized by the antibodies of the immune system. Immune checkpoint inhibitors, a type of cancer immunotherapy, are broadly used in different types of cancer, improving patients’ survival and quality of life. However, treatment with these agents causes immune-related toxicities affecting many organs. The most frequent pulmonary adverse event is pneumonitis representing a non-infective inflammation localized to the interstitium and alveoli. Other lung toxicities include airway disease, pulmonary vasculitis, sarcoid-like reactions, infections, pleural effusions, pulmonary nodules, diaphragm myositis and allergic bronchopulmonary aspergillosis. This review aims to summarize these pulmonary adverse events, underlining the significance of an optimal expeditious diagnosis and management.

show abstract

“…Pulmonary manifestations of radiation toxicity include radiation pneumonitis and radiation fibrosis [155]. Furthermore, radiation pneumonitis may be potentiated by concurrent or prior sensitizing anti-neoplastic medications [156].…”

Section: Ild Subgroupsmentioning

confidence: 99%

Interstitial Lung Disease and Pulmonary Fibrosis: A Practical Approach for General Medicine Physicians with Focus on the Medical History

Kalchiem‐Dekel

Galvin

Burke

et al. 2018

JCM

View full text Add to dashboard Cite

Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. In addition to the myriad of clinical and radiologic nomenclature used in ILD, histopathologic descriptors may be particularly confusing, and are often extrapolated to radiologic imaging patterns which may further add to the confusion. We propose that rather than focusing on precise histologic findings, focus should be on identifying an accurate etiology of ILD through a comprehensive and detailed medical history. Histopathologic patterns from lung biopsy should not be dismissed, but are often nonspecific, and overall treatment strategy and prognosis are likely to be determined more by the specific etiology of ILD rather than any particular histologic pattern. In this review, we outline a practical approach to common ILDs, highlight important aspects in obtaining an exposure history, clarify terminology and nomenclature, and discuss six common subgroups of ILD likely to be encountered by general medicine physicians in the inpatient or outpatient setting: Smoking-related, hypersensitivity pneumonitis, connective tissue disease-related, occupation-related, medication-induced, and idiopathic pulmonary fibrosis. Accurate diagnosis of these forms of ILD does require supplementing the medical history with results of the physical examination, autoimmune serologic testing, and chest radiographic imaging, but the importance of a comprehensive environmental, avocational, occupational, and medication-use history cannot be overstated and is likely the single most important factor responsible for achieving the best possible outcomes for patients.

show abstract

Fibrotic lung toxicity induced by cytotoxic drugs, radiation and immunotherapy in patients treated for lung cancer

Cited by 7 publications

References 20 publications

Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report

Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report

Pulmonary adverse events due to immune checkpoint inhibitors: A literature review

Interstitial Lung Disease and Pulmonary Fibrosis: A Practical Approach for General Medicine Physicians with Focus on the Medical History

Contact Info

Product

Resources

About