Tuberculosis and Respiratory Diseases

  • 제62권2호
  • /
  • Pages.134-139
  • /
  • 2007
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

Gefitinib 투여 후 발생한 간질성 폐렴

Gefitinib-Related Interstitial Pneumonia

  • Lee, Ho Jin (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Nam, Seung Bum (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Jung, Jae Wook (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Na, Im Il (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Kim, Cheol Hyeon (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Ryoo, Baek-Yeol (Department of Internal Medicine, Korea Cancer Center Hospital) ;
  • Choe, Du Whan (Department of Radiology, Korea Cancer Center Hospital) ;
  • Kang, Jin Hyung (Department of Internal Medicine, Kangnam St. Mary's Hospital) ;
  • Lee, Jae Cheol (Department of Internal Medicine, Korea Cancer Center Hospital)
  • 투고 : 2007.01.23
  • 심사 : 2007.02.22
  • 발행 : 2007.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Gefitinib은 진행성 비소세포성 폐암에 사용이 증가되고 있는 새로운 표적 항암 치료제로써 대부분이 경미한 부작용을 보이나 심각한 약제 유발성 간질성 폐렴이 발생 할 수 있다. 발생 빈도가 높은 일본에서는 유병률이 3.5%까지도 보고 된 바 있으나 현재 우리나라에서는 EAP에서 확인된 1건을 제외하고는 보고가 거의 없어 gefitinib로 인한 간질성 폐렴에 대한 낮은 인지도와 감별 진단의 어려움 등이 문제가 되는 것으로 판단된다. 저자들은 gefitinib에 의한 간질성 폐렴 2례를 경험하였기에 이를 보고하는 바이다.

Gefitinib is a novel drug used to treat advanced non-small cell lung cancer. However, drug-related interstitial pneumonia is a major life-threatening side effect, which has a worldwide prevalence of 0.3-0.4%. In Japan, the prevalence is high as 3-4% but the actual frequency in Korea has not been officially assessed. We report two cases of gefitinib-induced interstitial lung disease during the treatment of non-small cell lung cancer. High-resolution computerized tomography (HRCT) of one case showed nonspecific ground glass opacity and the chest x-ray of another case showed diffuse bilateral ground glass opacity. The former patient showed a rapid good response to corticosteroid treatment whereas the latter died despite receiving aggressive treatment with high dose corticosteroid and empirical antibiotics.

키워드

참고문헌

  1. Arteaga CL, Johnson DH. Tyrosine kinase inhibitors- ZD1839 (Iressa). Curr Opin Oncol 2001;13:491-8 https://doi.org/10.1097/00001622-200111000-00012
  2. Ciardiello F, Tortora G. A novel approach in the treatment of cancer: targeting the epidermal growth factor receptor. Clin Cancer Res 2001;7:2958-70
  3. Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard JY, et al. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer. J Clin Oncol 2003;21:2237-46 https://doi.org/10.1200/JCO.2003.10.038
  4. Inoue A, Saijo Y, Maemondo M, Gomi K, Tokue Y, Kimura Y, et al. Severe acute interstitial pneumonia and gefitinib. Lancet 2003;361:137-9 https://doi.org/10.1016/S0140-6736(03)12190-3
  5. Forsythe B, Faulkner K (2003b) Safety and tolerability of gefitinib ('Iressa', ZD1839) in advanced NSCLC: overview of clinical experience. Presentation at the ERS, Vienna, Austria, September 27- October 1, P327
  6. Ando M, Okamoto I, Yamamoto N, Takeda K, Tamura K, Seto T, et al. Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib. J Clin Oncol 2006;24:2549-56 https://doi.org/10.1200/JCO.2005.04.9866
  7. Kang JH, Kang SY, Kim HT, Lee JS, Shim BY, Park BB, et al. Retrospective Analysis of Patients with Advanced Non-Small Cell Lung Cancer Who Participated in the Extended Access Program (EAP) of Gefitinib. Presentation at the CELCC, Praque, Czech Republic, June 18-21, O20
  8. Expert Committee Meeting Report. Final report on interstitial lung disease (ILD) related to gefitinib (Iressa Tablet 250) by Iressa Expert Committee. AstraZeneca, March 26, 2003
  9. Camus P, Kudoh S, Ebina M. Interstitial lung disease associated with drug therapy. Br J Cancer 2004;91: S18-23 https://doi.org/10.1038/sj.bjc.6601891
  10. Muller NL, White DA, Jiang H, Gemma A. Diagnosis and management of drug-associated interstitial lung disease. Br J Cancer 2004;91:S24-30
  11. Endo M, Johkoh T, Kimura K, Yamamoto N. Imaging of gefitinib-related interstitial lung disease: multi-institutional analysis by the West Japan Thoracic Oncology Group. Lung Cancer 2006;52:135-40 https://doi.org/10.1016/j.lungcan.2006.02.002