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Cetuximab‐associated pulmonary toxicity in concurrent chemoradiation for the treatment of a squamous cell carcinoma of the head and neck
Author(s) -
Mayfield John D.,
Mercado Catherine E.,
Kaye Frederic J.,
Mendenhall William M.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25528
Subject(s) - cetuximab , medicine , head and neck cancer , head and neck squamous cell carcinoma , oncology , radiation therapy , lung cancer , interstitial lung disease , pulmonary toxicity , respiratory distress , egfr inhibitors , toxicity , cancer , lung , epidermal growth factor receptor , surgery , colorectal cancer
Background Cetuximab is a common EGFR monoclonal antibody used with radiotherapy to treat head‐and‐neck cancer. Severe pulmonary toxicity, including interstitial lung disease (ILD), caused by cetuximab is rare. Methods We describe a patient who developed ILD and acute respiratory failure after concurrent chemoradiation with cetuximab for oropharyngeal squamous cell carcinoma, and review the literature. Results A patient developed acute respiratory failure 2 months after starting concurrent chemoradiation with cetuximab and was hospitalized in intensive care after a procedure for progressive respiratory distress. Cultures and serology were negative for infection and radiologic findings were consistent with drug associated pneumonitits. Steroids were administered until the patient was stabilized. The patient fully recovered 1 month after the onset of respiratory distress, although he died of recurrent disease 10 months after completing treatment. Conclusion Although severe pulmonary toxicity caused by EGFR inhibitors has been well described in the literature, ILD caused by cetuximab, an EGFR monoclonal antibody, is rare and not well‐documented. Given its life‐threatening effects, awareness of this potential side effect and early diagnosis is critical.