BACKGROUND: Everolimus, an mTOR inhibitor with immunosuppressive properties, is used in several types of advanced tumors. Materials and METHODS: We describe the first two cases of Pneumocystis jirovecii pneumonia in patients given everolimus for metastatic pancreatic neuroendocrine tumors. RESULTS: The first patient presented with respiratory symptoms in the context of grade 4 lymphopenia 2 weeks after starting everolimus; the diagnosis of Pneumocystis jirovecii pneumonia was made post-mortem. After suspecting everolimus-related interstitial pneumonitis in the second patient, Pneumocystis jirovecii was detected, and cotrimoxazole therapy led to a favorable outcome. CONCLUSION: Everolimus may induce pneumonitis, lymphopenia and opportunistic infections. The time from treatment initiation to opportunistic infection may be short. Risk factors in oncology deserve further identification in order to start prophylaxis without delay.
BACKGROUND:Everolimus, an mTOR inhibitor with immunosuppressive properties, is used in several types of advanced tumors. Materials and METHODS: We describe the first two cases of Pneumocystis jirovecii pneumonia in patients given everolimus for metastatic pancreatic neuroendocrine tumors. RESULTS: The first patient presented with respiratory symptoms in the context of grade 4 lymphopenia 2 weeks after starting everolimus; the diagnosis of Pneumocystis jirovecii pneumonia was made post-mortem. After suspecting everolimus-related interstitial pneumonitis in the second patient, Pneumocystis jirovecii was detected, and cotrimoxazole therapy led to a favorable outcome. CONCLUSION:Everolimus may induce pneumonitis, lymphopenia and opportunistic infections. The time from treatment initiation to opportunistic infection may be short. Risk factors in oncology deserve further identification in order to start prophylaxis without delay.
Authors: José Baselga; Mario Campone; Martine Piccart; Howard A Burris; Hope S Rugo; Tarek Sahmoud; Shinzaburo Noguchi; Michael Gnant; Kathleen I Pritchard; Fabienne Lebrun; J Thaddeus Beck; Yoshinori Ito; Denise Yardley; Ines Deleu; Alejandra Perez; Thomas Bachelot; Luc Vittori; Zhiying Xu; Pabak Mukhopadhyay; David Lebwohl; Gabriel N Hortobagyi Journal: N Engl J Med Date: 2011-12-07 Impact factor: 91.245
Authors: P Di Cocco; G Orlando; L Bonanni; M D'Angelo; K Clemente; S Greco; G Gravante; F Madeddu; C Scelzo; A Famulari; F Pisani Journal: Transplant Proc Date: 2009-05 Impact factor: 1.066
Authors: James C Yao; Manisha H Shah; Tetsuhide Ito; Catherine Lombard Bohas; Edward M Wolin; Eric Van Cutsem; Timothy J Hobday; Takuji Okusaka; Jaume Capdevila; Elisabeth G E de Vries; Paola Tomassetti; Marianne E Pavel; Sakina Hoosen; Tomas Haas; Jeremie Lincy; David Lebwohl; Kjell Öberg Journal: N Engl J Med Date: 2011-02-10 Impact factor: 91.245
Authors: Robert J Motzer; Bernard Escudier; Stéphane Oudard; Thomas E Hutson; Camillo Porta; Sergio Bracarda; Viktor Grünwald; John A Thompson; Robert A Figlin; Norbert Hollaender; Gladys Urbanowitz; William J Berg; Andrea Kay; David Lebwohl; Alain Ravaud Journal: Lancet Date: 2008-07-22 Impact factor: 79.321
Authors: Annelieke E C A B Willemsen; Filip Y De Vos; Anne Jansen; Maaike de Boer; Vivianne C G Tjan-Heijnen; Carla M L van Herpen Journal: Target Oncol Date: 2014-03-05 Impact factor: 4.864