Interstitial lung disease induced by molecular targeted ...
Transcript of Interstitial lung disease induced by molecular targeted ...
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73 2 : 104-110, 2015
Interstitial lung disease induced by molecular targeted drugs
Akinobu YOSHIMURA
Department of Clinical Oncology, Tokyo Medical University Hospital
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27 1 17 27 3 13: Molecular targeted drugs interstitial lung disease epidemiology
CT high resolution CT: 160-0023 6-7-1
TEL : 03-3342-6111 2161 FAX : 03-3342-6211
EGFREGFR-TKI
Bevacizumab SunitinibEGFR-TKI
EGFR-TKI
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PMDA1 1
2009
25%
: 1052015 4
50%1
2-17
AfatinibCrizotinib Alectinib Imatinib
Gemcitabine 1.7% Pemetrexed3.6%
1% 1Sorafenib Sunitinib Bevacizumab
5% 1.2-
22.9%
EGFR-TKI Ge -tinib Erlotinib
39% 75/193 37% 153/429EGFR Cetuximab Panitumumab1.2% 1.3%
42% 10/24 63% 20/39mTOR
Everolimus Temsirolimus22.9% 7.8%
3.3% 8/244 7.7% 6/78
Ge tinib PS2 Erlotinib
COPDPS2 2 3
Ge tinib
Ge tinib3.2
Ge tinib PS
18 Ge tinib
EGFR-TKI5.8% 0.3% 20
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Bleomycin0.01%
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0.66% 60 19
EGFR-TKI
20 EGFR-TKI
DNADNA
MUC4EGFR-TKI
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diffuse alveolar damage ; DADorganizing pneumonia ; OPnonspeci c interstitial pneumonia ; NSIP
eosinophlic pneumonia ; EP
hypersensitivity pneumonia ; HP
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Targets Drugs Incidence rate Mortality rate
Small-molecule targeted drugsEGFR Ge tinib* 5.8% 193/3,322 2.3% 75/3,322
Erlotinib* 4.3% 429/9,909 1.5% 153/9,909Afatinib** 3.1% 4/128
ALK Crizotinib** 1.8% 22/1,225 0.2% 3/1,225Alectinib** 1.7% 1/58 0.0% 0/58
BCR-ABL, KIT, PDGFR Imatinib*** < 5%Dasatinib* 2.9% 24/838Nilotinib* 1.3% 11/848 0.4% 3/848
VEGFR, PDGFR, FLT3 + Sorafenib* 0.4% 12/3,054 0.2% 6/3,054Sunitinib* 0.7% 15/2,141 0.1% 3/2,141
mTOR Everolimus* 22.9% 244/1,067 0.7% 8/1,067Temsirolimus* 7.8% 78/1,004 0.6% 6/1,004
Proteasome Bortezomib* 4.5% 45/1,010 0.5% 5/1,010
Monoclonal antibodiesEGFR Cetuximab* 1.2% 24/2,006 0.5% 10/2,006
Panitumumab* 1.3% 39/3,085 0.6% 20/3,085VEGF Bevacizumab* 0.4% 10/2,698 0.1% 2/2,698
According to post-marketing surveillance * , clinical study ** and pharmaceutical reference ***
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