Characterisation of the lung toxicity of the cell cycle inhibitor temsirolimus

Duran, I.; Siu, L.L.; Oza, A.M.; Chung, T.-B.; Sturgeon, J.; Townsley, C.A.; Pond, G.R.; Seymour, L.; Niroumand, M.

doi:10.1016/j.ejca.2006.03.015

« Previous Next »European Journal of Cancer
Volume 42, Issue 12 , Pages 1875-1880, August 2006

Characterisation of the lung toxicity of the cell cycle inhibitor temsirolimus

I. Duran
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
L.L. Siu
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
- Corresponding author: Tel.: +1 416 946 2911; fax: +1 416 946 4467.
A.M. Oza
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
T.-B. Chung
- Princess Margaret Hospital, University Health Network, Department of Diagnostic Imaging, Toronto, Canada
J. Sturgeon
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
C.A. Townsley
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
G.R. Pond
- Princess Margaret Hospital, University Health Network, Department of Medical Oncology and Haematology, 610 University Avenue, Suite 5-718, Toronto, Ont., Canada M5G 2M9
L. Seymour
- National Cancer Institute of Canada Clinical Trials Group, Kingston, Canada
M. Niroumand
- Mount Sinai Hospital, Department of Respirology, Toronto, Canada

Received 9 November 2005; received in revised form 17 March 2006; accepted 21 March 2006.

Abstract

The aims of this study were reviewing our experience regarding the pulmonary toxicity of the mammalian target of rapamycin (mTOR) inhibitor temsirolimus, discussing potential pathogenic mechanisms and proposing management strategies. Medical records and radiological reports of 22 patients treated with weekly doses of temsirolimus 25mg were reviewed. Eight (36%) out of 22 patients developed pulmonary abnormalities compatible with drug-induced pneumonitis. Half were asymptomatic and in those with symptoms, dyspnea and dry cough were the most common. Radiologically two different patterns, ground glass opacities and lung parenchymal consolidation, were described. The management of this toxicity was variable, ranging from no intervention to discontinuation of the drug. In our experience temsirolimus may cause drug-induced pneumonitis at a higher incidence than that previously reported. The presentation and its severity are variable. The risk of developing this toxicity may be increased among subjects with abnormal pre-treatment pulmonary functions or history of lung disease.