Interstitial Lung Disease Induced by Pazopanib Treatment

Abstract

Although pneumothorax has been reported to be a major pulmonary adverse event in patients treated with pazopanib, a multikinase inhibitor, drug-induced interstitial lung disease (DILD) has not been reported. A 74-year-old Japanese man who received pazopanib for the treatment of femoral leiomyosarcoma and lung metastasis presented with dyspnea and fatigue. He had mild interstitial pneumonia when pazopanib treatment was initiated. Chest computed tomography revealed progressive bilateral ground-glass opacity (GGO) and traction bronchiectasis. We diagnosed DILD due to pazopanib. The patient's pazopanib treatment was interrupted and a steroid was administered. The symptoms and GGO were improved with treatment. Physicians should be aware of DILD due to pazopanib in patients with pre-existing interstitial lung disease.

Figure 1.

Chest computed tomography from the start of pazopanib therapy. (A) Lung metastases from leiomyosarcoma and (B) pre-existing interstitial lung disease are observed.

Figure 2.

The clinical course of the present case.

Figure 3.

The radiological findings on admission are shown. (A) Chest radiography shows bilateral peripheral reticular shadows. Chest computed tomography demonstrates bilateral diffuse ground-glass opacity and the progression of traction bronchiectasis (B) on the day of admission, (C) partial improvement on the 8th day of treatment, and (D) recurrence of interstitial pneumonia on the 42nd day.