Pulmonary toxicities from targeted therapies: A review

Nicholas A. Barber, Apar Kishor Ganti

Research output: Contribution to journalReview article

57 Scopus citations

Abstract

Pulmonary toxicity is rarely seen with most commonly used targeted therapies. The endothelial growth factor receptor (EGFR) small-molecule tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib can cause interstitial lung disease (ILD). BCR-ABL tyrosine kinase inhibitors imatinib and dasatinib can cause pleural effusions. Infusion-related bronchospasm is common with the monoclonal antibodies to EGFR cetuximab and panitumumab, and case reports of bronchiolitis and pulmonary fibrosis have been described. Up to one-sixth of patients taking mammalian target of rapamycin (mTOR) inhibitors get a reversible interstitial pneumonitis. Bevacizumab, the monoclonal antibody to vascular endothelial growth factor (VEGF), has been associated with hemoptysis and pulmonary embolism particularly in patients with squamous cell lung cancer. Infusion-related bronchospasms, acute respiratory distress syndrome (ARDS), and interstitial pneumonitis can be seen with the anti-lymphocyte monoclonal antibodies rituximab, ofatumumab, and alemtuzumab. While most pulmonary toxicities from these therapies are mild and resolve promptly with dose reduction or discontinuation, it is important for the clinician to recognize these potential toxicities when faced with treatment-related complications. Discerning these pulmonary adverse effects may help in making decisions on diagnostic testing and therapy, particularly for those with pulmonary and cardiovascular co-morbidities.

Original languageEnglish (US)
Pages (from-to)235-243
Number of pages9
JournalTargeted Oncology
Volume6
Issue number4
DOIs
StatePublished - Dec 1 2011

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Keywords

  • Dasatinib
  • Erlotinib
  • Gefitinib
  • Interstitial pneumonitis
  • Non-specific acute interstitial lung disease
  • Pulmonary toxicity
  • Targeted therapy
  • mTOR inhibitors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Pharmacology (medical)

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