Bortezomib therapy‐related lung disease in Japanese patients with multiple myeloma: Incidence, mortality and clinical characterization

Cancer Science

Kazutake Yoshizawa⁹  Harumi Y. Mukai⁹  Michiko Miyazawa²  Makiko Miyao²  Yoshimasa Ogawa²  Kazuma Ohyashiki⁵  Takao Katoh³  Masahiko Kusumoto⁴  Akihiko Gemma⁷  Fumikazu Sakai⁶  Yukihiko Sugiyama⁸  Kiyohiko Hatake¹  Yuh Fukuda^9,10 

[1]Department of Hematology Oncology, Cancer Institute Hospital, Tokyo, Japan

[2]Division of Research and Development, Janssen Pharmaceutical K.K., Tokyo, Japan

[3]Division of Cardiology, Hepatology, Geriatrics and Integrated Medicine, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan

[4]Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

[5]First Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan

[6]Department of Radiology, Saitama Medical University International Medical Center, Hidaka-shi, Japan

[7]Division of Pulmonary Medicine, Infectious Disease and Oncology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan

[8]Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan

[9]Division of Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan

[10]Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan

关键词: Bortezomib;    lung disease;    mortality;    multiple myeloma;    proteasome inhibitors;   

DOI  :  10.1111/cas.12335

来源: Wiley

【 摘 要 】

Abstract

Because of the potentially high mortality rate (6.5%) associated with bortezomib-induced lung disease (BILD) in Japanese patients with relapsed or refractory multiple myeloma, we evaluated the incidence, mortality and clinical features of BILD in a Japanese population. This study was conducted under the Risk Minimization Action Plan (RMAP), which was collaboratively developed by the pharmaceutical industry and public health authority. The RMAP consisted of an intensive dissemination of risk information and a recommended countermeasure to health-care professionals. All patients treated with bortezomib were consecutively registered in the study within 1 year and monitored for emerging BILD. Of the 1010 patients registered, 45 (4.5%) developed BILD, 5 (0.50%) of whom had fatal cases. The median time to BILD onset from the first bortezomib dose was 14.5 days, and most of the patients responded well to corticosteroid therapy. A retrospective review by the Lung Injury Medical Expert Panel revealed that the types with capillary leak syndrome and hypoxia without infiltrative shadows were uniquely and frequently observed in patients with BILD compared with those with conditions associated with other molecular-targeted anticancer drugs. The incidence rate of BILD in Japan remains high compared with that reported in other countries, but the incidence and mortality rates are lower than expected before the introduction of bortezomib in Japan. This study describes the radiographic pattern and clinical characterization of BILD in the Japanese population. The RMAP seemed clinically effective in minimizing the BILD risk among our Japanese population.

【 授权许可】

CC BY-NC-ND   
© 2013 Janssen Pharmaceutical K.K. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

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