Complete remission and fatal interstitial pneumonitis related to nab‐paclitaxel in refractory small cell lung cancer: A case report and review of the literature

Thoracic Cancer

Binchao Wang²  Jinji Yang²  Donglan Luo¹  Huixian Qiao⁴  Zhi Xie³  Xuchao Zhang² 

[1] Department of Pathology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China;Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China;Medical Research Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China;Department of Nuclear Medicine, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China

关键词: Interstitial pneumonitis;    nab‐paclitaxel;    small cell lung cancer;   

DOI  :  10.1111/j.1759-7714.2011.00086.x

来源: Wiley

【 摘 要 】

Abstract

For refractory or resistant small cell lung cancer (SCLC), there is no standard treatment. We report a case of refractory SCLC achieving complete remission and then developing fatal interstitial pneumonitis after treatment with single-agent nab-paclitaxel. The relevant literature has also been reviewed. In terms of effectiveness, evidences exists that some refractory or resistant SCLC patients respond to paclitaxel, including nab-paclitaxel and solvent-based paclitaxel. Paclitaxel-related fatal interstitial pneumonitis is an uncommon event, with five fatal cases reported in the literature. It appears to occur in weekly paclitaxel-treated patients and develop during the middle-to-late phase of treatment. Therefore, further randomized clinical trials should be encouraged. In our case, positive immunohistochemical analysis for caveolin-1 in the tumor vascular endothelia suggests that the complete response may have been facilitated by enhanced transportation of paclitaxel through the tumor vascular barrier via caveolin-1, despite being negative for secreted protein acidic and rich in cysteine (SPARC) in tumor cells. Further molecular investigations of gp60, caveolin-1 and SPARC will shed light on tailored treatment in this setting.

【 授权许可】

Unknown   
© 2011 Tianjin Lung Cancer Institute and Blackwell Publishing Asia Pty. Ltd