The Drug-Induced Respiratory Disease Website
(Fr: PINS aiguë). Acute, generally bilateral and diffuse pneumonitis. More rapid in onset and/or denser, more extensive and severe than pattern Ib. Can be fulminate in the form of diffuse pulmonary interstitial or alveolar opacities and the ARDS picture (see under IIb). BAL is generally lymphocytic and is also indicated to rule out pneumonia due to Pneumocystis, BCG, viruses or other agents particularly in the immunodepressed. Pathology (lung biopsy is not necessary in the majority; before going for the biopsy, please look at PMID 25950989) may disclose dense NSIP, widespread granulomas, or OP depending both on patient and drug. In severe cases pulmonary edema, DAD and/or DAH may develop. Corticosteroid therapy is indicated if patients progress to acute respiratory failure, once an infection has been carefully and resonably ruled out. Transition to pulmonary fibrosis is very uncommon. The boundary between patterns Ia and Ib may be difficult to delineate. See also under IIb
Publications
Wekking D, Porcu M, Pellegrino B, Lai E, Mura G, Denaro N, Saba L, Musolino A, Scartozzi M, Solinas C
Multidisciplinary clinical guidelines in proactive monitoring, early diagnosis, and effective management of trastuzumab deruxtecan (T-DXd)-induced interstitial lung disease (ILD) in breast cancer patients.
ESMO open 2023 Nov 09;8;102043 — 2023 Nov 09 — 102043
Powell CA, Modi S, Iwata H, Takahashi S, Smit EF, Siena S, Chang DY, Macpherson E, Qin A, Singh J, Taitt C, Shire N, Camidge DR
Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies.
ESMO open 2022 Aug 10;7;100554 — 2022 Aug 10 — 100554
Trastuzumab Deruxtecan-Induced Interstitial Lung Disease/Pneumonitis in ERBB2-Positive Advanced Solid Malignancies: A Systematic Review.
Drugs 2022 Jun;82;979-987 — 2022 Jun — 979-987
Cortés J, Kim SB, Chung WP, Im SA, Park YH, Hegg R, Kim MH, Tseng LM, Petry V, Chung CF, Iwata H, Hamilton E, Curigliano G, Xu B, Huang CS, Kim JH, Chiu JWY, Pedrini JL, Lee C, Liu Y, Cathcart J, Bako E, Verma S, Hurvitz SA,
Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer.
The New England journal of medicine 2022 Mar 24;386;1143-1154 — 2022 Mar 24 — 1143-1154
Li BT, Smit EF, Goto Y, Nakagawa K, Udagawa H, Mazières J, Nagasaka M, Bazhenova L, Saltos AN, Felip E, Pacheco JM, Pérol M, Paz-Ares L, Saxena K, Shiga R, Cheng Y, Acharyya S, Vitazka P, Shahidi J, Planchard D, Jänne PA,
Trastuzumab Deruxtecan in -Mutant Non-Small-Cell Lung Cancer.
The New England journal of medicine 2021 Sep 18;; — 2021 Sep 18
Modi S, Saura C, Yamashita T, Park YH, Kim SB, Tamura K, Andre F, Iwata H, Ito Y, Tsurutani J, Sohn J, Denduluri N, Perrin C, Aogi K, Tokunaga E, Im SA, Lee KS, Hurvitz SA, Cortes J, Lee C, Chen S, Zhang L, Shahidi J, Yver A, Krop I,
Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer.
The New England journal of medicine 2019 Dec 11;; — 2019 Dec 11
Shitara K, Iwata H, Takahashi S, Tamura K, Park H, Modi S, Tsurutani J, Kadowaki S, Yamaguchi K, Iwasa S, Saito K, Fujisaki Y, Sugihara M, Shahidi J, Doi T
Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive gastric cancer: a dose-expansion, phase 1 study.
The Lancet. Oncology 2019 Jun;20;827-836 — 2019 Jun — 827-836
Tamura K, Tsurutani J, Takahashi S, Iwata H, Krop IE, Redfern C, Sagara Y, Doi T, Park H, Murthy RK, Redman RA, Jikoh T, Lee C, Sugihara M, Shahidi J, Yver A, Modi S
Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive breast cancer previously treated with trastuzumab emtansine: a dose-expansion, phase 1 study.
The Lancet. Oncology 2019 Jun;20;816-826 — 2019 Jun — 816-826