| アブストラクト | BACKGROUND: PARP inhibitors (PARPi) are used in the treatment of ovarian, breast, pancreatic, and prostate cancers. Pneumonitis has been identified as a potential side effect, with a higher meta-analysis-assessed risk for olaparib versus other PARPi. Olaparib-induced interstitial lung disease (O-ILD) was first described within the Japanese population, with few information available for Caucasian patients. METHODS: We performed a retrospective study by pooling data from the French and Belgian pharmacovigilance databases from 2018 to 2022. Patients with O-ILD were included following a central review by: 1) pharmacologists using the French drug causality assessment method; 2) senior pneumologists or radiologists, using the Fleischner Society's recommendations. RESULTS: Five patients were identified and analysed. All were females, with ovarian or breast cancer. Median age at O-ILD diagnosis was 71 (38-72) years old, with no smoking history. Median delay between treatment initiation and symptom occurrence was 12 (6-33) weeks. Pneumonitis severity assessed using the Common Terminology Criteria for Adverse Events V5 was Grade 3 (n = 4) or 2 (n = 1). CT-scan review (n = 3) described hypersensitivity pneumonitis reaction as a common pattern. Bronchioalveolar lavage (n = 4) revealed lymphocytic alveolitis. Treatments relied on olaparib discontinuation (n = 5) and glucocorticoid intake (n = 4), with no fatal issue. Safe re-challenge with PARPi occurred in two patients. Forty additional O-ILD cases were identified in the WHO VigiBase database, including one fatal case. CONCLUSIONS: PARPi-ILD is a rare but potentially life-threatening disease, presenting as a hypersensitivity pneumonitis pattern within 3 months of PARPi initiation. Treatment primarily relies on medication discontinuation. Re-challenging with another PARPi could be considered. CLINICAL TRIAL NUMBER: CEPRO #2023-010. |
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| 投稿者 | Brudon, Alexandre; Fournier, Dorine; Selle, Frederic; Seront, Emmanuel; Conforti, Rosa; Veyrac, Gwenaelle; Gouraud, Aurore; Lebrun-Vignes, Benedicte; Khalil, Antoine; Zalcman, Gerard; Gounant, Valerie |
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| 組織名 | Thoracic Oncology Department, Universite Paris Cite, CIC INSERM 1425, Institut du;Cancer AP-HP.Nord, Hopital Bichat-Claude Bernard, 46 Rue Henri Huchard, Paris,;75108, France. alexandre.brudon01@chu-lyon.fr.;Service de Pharmacologie Medicale, Centre Regional de Pharmacovigilance;Pitie-Saint-Antoine, Groupe Hospitalier AP-HP-Sorbonne Universite, Paris, 75013,;France.;Department of Medical Oncology, Hopital Diaconesses Croix Saint Simon, Paris,;75020, France.;Department of Medical Oncology, Hopital Jolimont, Haine-Saint-Paul, La Louviere,;7100, Belgique.;Department of Medical Oncology, Sorbonne UniversiteHopital Pitie Salpetriere,;APHP, Paris, 75011, France.;Clinical Pharmacology Department, CHU Nantes, Nantes, France.;Service Hospitalo-Universitaire de Pharmaco-Toxicologie (SHUPT), Hospices Civils;de Lyon, 162, Avenue Lacassagne, Lyon, 69424, France.;Department of Radiology, Universite Paris Cite, Hopital Bichat-Claude Bernard,;Institut du Cancer Paris Nord, APHP, Universite Paris Cite, Paris, 75018, France.;75108, France. |
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