Pneumotox » Drug » Sunitinib

Sunitinib

In renal cell carcinoma patients on sunitinib, separation of ILD or DAH from pulmonary metastatic disease can be exceedingly difficult (PMID 19289369)

Last update : 15/10/2014

I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

I.b Pneumonitis (ILD)

II.d Pulmonary edema, cardiogenic

III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

V.a Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

V.m Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)

VI.a Pulmonary embolism - Venous thrombosis/thromboembolism

XII.a Left or biventricular dysfunction/failure

XII.r Heart failure (biventricular, congestive)

XII.ai Cardiotoxicity

XVI.bf Imaging: Tumoral cavitation

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France