AI Article Synopsis
- Everolimus, an anti-cancer drug, is linked to a high rate of interstitial lung disease (ILD), but its clinical and pathological effects are not well studied.
- A study analyzed medical records of 66 patients treated with everolimus, finding that 19 developed ILD, with varying severity but no demographic differences between affected and unaffected patients.
- Chest CT scans indicated patterns like organizing pneumonia, and higher biomarkers correlated with ILD onset, while lung biopsies revealed significant inflammatory features; overall, ILD from everolimus is generally mild and tends to have a good prognosis.
Article Abstract
Background: Everolimus, a mammalian target of rapamycin inhibitor used as an antineoplastic drug, is associated with a remarkably high incidence of interstitial lung disease (ILD). The clinical and pathological characteristics of ILD caused by everolimus have not been thoroughly investigated; therefore, we aimed to elucidate the features of everolimus-associated ILD.
Methods: We retrospectively reviewed the medical records of patients who received everolimus for cancer treatment at our hospital. Patient backgrounds were compared between the ILD and non-ILD groups. Chest computed tomography (CT), changes in biomarkers, and lung histopathological features were analyzed for ILD cases.
Results: Sixty-six patients were reviewed, and ILD developed in 19. There were no differences in patient demographics between the ILD and non-ILD groups. The severity of ILD was grade 1 (G1) in 9 and grade 2 (G2) in 10 cases. Chest CT showed organizing pneumonia (OP) or a hypersensitive pneumonia pattern. The levels of lactate dehydrogenase, C-reactive protein, Krebs von den lungen-6, and surfactant protein-D (SP-D) at the onset of ILD were significantly higher than those at baseline. Analysis of G1 and G2 ILD subgroups showed a higher SP-D levels in the G2 subgroup. Five patients underwent lung biopsies; all specimens demonstrated alveolitis with lymphocytic infiltration and granulomatous lesions, and some had OP findings.
Conclusions: Everolimus-associated ILD is mild and has a favorable prognosis. Patients with symptomatic ILD were more likely to have higher SP-D levels than those with asymptomatic ILD. Granulomatous lesions are an important pathological feature of everolimus-associated ILD.
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| http://dx.doi.org/10.1272/jnms.JNMS.2024_91-211 | DOI Listing |
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