Pneumonitis associated with mTOR inhibitors therapy in patients with metastatic renal cell carcinoma: Incidence, radiographic findings and correlation with clinical outcome
European Journal of Cancer, 04/11/2012
Dabydeen DA et al. – Preliminary data suggest that pneumonitis may be a marker of stable disease by RECIST and therefore, of therapeutic benefit.Methods
- We retrospectively reviewed the clinical data and serial CT scans from patients with mRCC treated with either temsirolimus or everolimus.
- Serial chest CT scans were reviewed in consensus, read by two independent radiologists for the presence of pneumonitis, and corresponding clinical data were reviewed for symptoms and clinical outcome.
- The baseline and follow up CTs were reviewed to assess outcome to therapy.
- The study population consisted of 46pts, 21 treated with temsirolimus and 25 with everolimus (M:F 2.5:1; median 63years, range 31–79years).
- CT evidence of pneumonitis was seen in 14/46pts (30%), at a median of 56days on mTOR inhibitor treatment (range 31–214days).
- Respiratory symptoms at the time of radiographically detected pneumonitis, were observed in 7pts.
- Stable disease (SD) by Response Evaluation Criteria in Solid Tumours (RECIST) was achieved in 12/14pts (86%) who developed radiographic pneumonitis compared to 14/32 (44%) without pneumonitis (p=0.01) The mean change of tumour long axis size for target lesions by RECIST, normalised for 30days on therapy was –2.9% in the pneumonitis group and +4.3% in the non-pneumonitis group (p=.002).