© 2015 INTM, Italy. Published by Wichtg Publishing TJ ISSN 0300-8916 Tumori 2015; 101(3): e92-e95 CASE REPORT sttal pulmonary injury due to this drug used as second-line therapy for advanced NSCLC and we reviewed the literature on the subject. Case report 1 A 73-year-old former smoker, afer frst-line chemothera- py with a carboplatn-gemcitabine regimen, was undergoing second-line chemotherapy with weekly docetaxel (30 mg/m 2 / week) for right adrenal gland and abdominal lymph node re- currence of previously resected lung adenocarcinoma, EGFR wild-type. Afer 3 courses of well-tolerated chemotherapy, the patent underwent a restaging CT scan that showed a par- tal response of the metastases in the right adrenal gland and stable disease in the lymph nodes. Chest CT scan revealed DOI: 10.5301/tj.5000275 A commentary on intersttal pneumonits induced by docetaxel: clinical cases and systematc review of the literature Giovenzio Genestret 1 , Monica Di Batsta 1 , Rocco Trisolini 2 , Fabio Denicolò 3 , Mirca Valli 4 , Luigi Arcangelo Lazzari-Agli 5 , Giorgia Dal Piaz 6 , Dario De Biase 7 , Marco Bartolot 1 , Giovanna Cavallo 1 , Alba A. Brandes 1 1 Department of Clinical Oncology, AUSL Bologna, Bologna - Italy 2 Department of Pneumology, AUSL Bologna, Bologna - Italy 3 Department of Radiology, AUSL Rimini, Cervesi Hospital, Catolica, Rimini - Italy 4 Department of Pathology, AUSL Rimini, Infermi Hospital, Rimini - Italy 5 Department of Pneumology, AUSL Rimini, Ceccarini Hospital, Riccione - Italy 6 Department of Radiology, AUSL Bologna, Bologna - Italy 7 Department of Medicine, Anatomic Pathology Unit, AUSL Bologna, Bologna - Italy Introducton Docetaxel is a taxane used worldwide for several malig- nancies including non-small cell lung cancer (NSCLC). A very rare and severe side efect is intersttal pneumonits. We report the successful management of 2 cases of severe inter- ABSTRACT Background: Pulmonary toxicity is a well-known complicaton observed with several antcancer drugs. Docetaxel, a taxane chemotherapy drug widely used in the treatment of many types of solid tumors including non-small cell lung cancer (NSCLC), rarely causes infltratve pneumonits. The exact mechanism by which docetaxel develops this side efect is not well understood; probably it is produced by type I and IV hypersensitvity responses. Here we describe 2 cases of infltratve pneumonits induced by docetaxel as second-line chemotherapy in advanced NSCLC. Materials and Methods: Two patents with advanced NSCLC were treated with weekly docetaxel as second-line chemotherapy. Afer 3 courses of chemotherapy, restaging computed tomography (CT) of the chest revealed bilateral difuse ground-glass opacites with a peribronchial distributon possibly indicatve of hypersensitvity pneumonits. No evidence of pulmonary embolus or pleural efusion was found. Fiberoptc bronchoscopy showed normal bronchi without lymphangits; biopsies showed intersttal fbrosis without tumor cells. Bronchial tssue laboratory tests for fungi or bacilli were negatve. No malignant cells were found at bronchoalveolar lavage. The patents were given high-dose cortcosteroid therapy with prednisone 0.7 mg per kilogram per day. Results: Afer 1 month of therapy, contrast-enhanced chest CT showed complete disappearance of the pulmo- nary changes in both patents. Spirometry and blood gas analysis revealed complete recovery of pulmonary func- ton. The patents contnued their oncological follow-up program. Conclusions: Pulmonary injury is a rare adverse event during docetaxel chemotherapy. Prompt treatment with high-dose cortcosteroids is needed to avoid worsening of respiratory performance. Keywords: Docetaxel, Drug-induced toxicity, Lung cancer, Pulmonary injury Accepted: October 2, 2014 Published online: April 9, 2015 Corresponding author: Giovenzio Genestret, MD Department of Clinical Oncology, AUSL Bologna Via Altura 3, 40139 Bologna, Italy g.genestret@ausl.bo.it