Docetaxel-Induced Pneumonitis in a Patient With Metastatic Lung Adenocarcinoma

Abstract

Docetaxel is a taxane anti-neoplastic agent commonly used in the treatment of solid-organ tumours. Here, we describe a case of a patient with metastatic lung adenocarcinoma who had disease progression following initial treatment with a combination of pembrolizumab, pemetrexed and carboplatin. She received three cycles of docetaxel and had a favourable oncological response but was admitted for breathlessness following the third cycle. A repeat computed tomography scan of the thorax showed predominantly right-sided ground-glass opacities and consolidation. The patient underwent high-risk bronchoscopy and bronchoalveolar lavage. Once infection was confidently ruled out, she was started on high-dose steroid therapy and responded to treatment.

Keywords: diffuse lung disease; docetaxel; drug-induced interstitial lung disease (di-ild); drug-induced pneumonitis; oncology.

Figure 1. Computed tomography (CT) scan of the thorax done after three cycles of docetaxel, showing patchy areas of ground-glass and consolidation, predominantly in the right lung (indicated by the black arrow)

Figure 2. Chest radiograph showing interval development of bilateral hazy infiltrates over both lung fields

Figure 3. Computed tomography (CT) scan of the thorax done on D60 of admission, showing interval improvement of bilateral consolidation, with residual fibrosis (traction bronchiectasis and reticular infiltrates, as indicated by the black arrow)