Concurrent trastuzumab deruxtecan-induced interstitial lung disease and COVID-19 in the treatment of advanced breast cancer.
Naoaki YasudaSatoshi IkeoAkihiko SokaiYuki SakaiYasuyuki HayashiSae KitanoNaoko ItoiTecchuu LeeToshiyuki IwataTakashi NishimuraPublished in: Oxford medical case reports (2023)
Patients with cancer are at an increased risk of developing coronavirus disease 2019 (COVID-19) infection. Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate (ADC) against epidermal growth factor receptor 2 (HER2)-positive cancer, known to cause drug-induced interstitial lung disease (DILD), including drug-induced pneumonitis. A 60-year-old woman with breast cancer developed a fever during treatment with T-DXd and was diagnosed with COVID-19. The fever persisted for approximately 3 weeks, and chest computed tomography showed multiple consolidations with bilateral peripheral predominance. Since the clinical course was atypical for COVID-19 due to the long duration of the fever and the CT pattern was frequently seen in T-DXd-induced ILD, the patient was diagnosed with T-DXd-induced ILD, following which, prednisolone was started, leading to improvement in the symptoms and fading of shadows. Even in patients suspected of COVID-19 pneumonia, physicians should consider the possibility of DILD, particularly in patients undergoing cancer treatment.
Keyphrases
- interstitial lung disease
- drug induced
- coronavirus disease
- liver injury
- systemic sclerosis
- epidermal growth factor receptor
- rheumatoid arthritis
- sars cov
- idiopathic pulmonary fibrosis
- computed tomography
- patients undergoing
- tyrosine kinase
- high glucose
- diabetic rats
- respiratory syndrome coronavirus
- primary care
- advanced non small cell lung cancer
- end stage renal disease
- newly diagnosed
- adverse drug
- case report
- positron emission tomography
- pulmonary embolism
- squamous cell carcinoma
- contrast enhanced
- peritoneal dialysis
- cancer therapy
- intensive care unit
- young adults
- stress induced
- smoking cessation
- childhood cancer