Interstitial Lung Disease Associated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy in Non–Small-Cell Lung Carcinoma

Interstitial lung disease is a rare but serious complication of epidermal growth factor receptor tyrosine kinase inhibitor therapy. Although our understanding of this phenomenon remains incomplete, recently there have been significant insights made into the mechanisms of injury, incidence, risk factors, and its clinical manifestatons. Japanese patients appear to be at a higher risk (1.6%–3.5%) than patients in the rest of the world (0.3%), and other risk factors, such as coincident interstitial lung disease, concurrent chemotherapy, previous radiaton, preexisting pulmonary fibrosis, and male sex, have been identified. In the majority of cases, the histopathology, the acute and often dramatic clinical persentation, and the radiographic findings resemble acute respiratory distress syndrome. Aside from immediate cessation of the offending agent, the treatment is largely supportive, although corticosteroids appear to be of benefit. The mortality remains high at approximately 30%–50%. We present a review of the incidence, risk factors, clinical manifestations, diagnosis, management, and outcome of this disorder.