Cetuximab‐associated pulmonary toxicity in concurrent chemoradiation for the treatment of a squamous cell carcinoma of the head and neck

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 concu...

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Bibliographic Details
Published in:Head & neck 2019-04, Vol.41 (4), p.E55-E58
Main Authors: Mayfield, John D., Mercado, Catherine E., Kaye, Frederic J., Mendenhall, William M.
Format: Article
Language:English
Subjects:
cetuximab
chemoradiation
Chemoradiotherapy
Epidermal growth factor receptors
Head & neck cancer
Head and neck
head and neck cancer
Immunotherapy
Lung cancer
Lung diseases
Monoclonal antibodies
Neck
oropharynx
Patients
pulmonary toxicity
Radiation therapy
Respiratory failure
Respiratory therapy
Serology
Squamous cell carcinoma
Steroid hormones
Targeted cancer therapy
Toxicity
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Summary: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.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.25528