Acute eosinophilic pneumonia: a fatal reaction to ado-trastuzumab

BMJ Case Rep. 2021 Sep 3;14(9):e243881. doi: 10.1136/bcr-2021-243881.

Abstract

Ado-trastuzumab emtansine (T-DM1) is a monoclonal antibody drug conjugate approved for the treatment of HER2-positive breast cancers. Presented here is a case report of a patient who developed fatal pulmonary toxicity in the form of acute eosinophilic pneumonia while undergoing treatment with T-DM1. Prior to beginning T-DM1 therapy, this patient had been treated with two HER2-targeted agents (trastuzumab, pertuzumab) per National Comprehensive Cancer Network (NCCN) guidelines. This case represents a novel presentation of toxicity associated with T-DM1 while perhaps demonstrating additive toxicity associated with multiple lines of HER2 targeted therapies.

Keywords: breast cancer; chemotherapy; interstitial lung disease; pneumonia (respiratory medicine); unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Ado-Trastuzumab Emtansine
  • Breast Neoplasms* / drug therapy
  • Female
  • Humans
  • Maytansine* / adverse effects
  • Pulmonary Eosinophilia* / chemically induced
  • Pulmonary Eosinophilia* / diagnosis
  • Receptor, ErbB-2
  • Trastuzumab / adverse effects

Substances

  • Maytansine
  • Receptor, ErbB-2
  • Trastuzumab
  • Ado-Trastuzumab Emtansine